Healthcare Provider Details

I. General information

NPI: 1437211125
Provider Name (Legal Business Name): APRIL SHANELL BRIDDELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9302 SAMFORD CT
DELMAR MD
21875-2275
US

IV. Provider business mailing address

PO BOX 1163
SALISBURY MD
21802-1163
US

V. Phone/Fax

Practice location:
  • Phone: 252-367-1153
  • Fax:
Mailing address:
  • Phone: 252-367-1153
  • Fax: 919-375-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25716
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: