Healthcare Provider Details

I. General information

NPI: 1639096670
Provider Name (Legal Business Name): ANGELICA LORRAINE BRIDGES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8024 GLENWOOD AVE STE 280
RALEIGH NC
27612-1952
US

IV. Provider business mailing address

PO BOX 8879
ASHEVILLE NC
28814-8879
US

V. Phone/Fax

Practice location:
  • Phone: 866-700-1606
  • Fax: 866-338-5921
Mailing address:
  • Phone: 866-700-1606
  • Fax: 866-338-5921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: