Healthcare Provider Details

I. General information

NPI: 1104226240
Provider Name (Legal Business Name): ANGELA MCINVALE MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 ASHLEY TOWN CENTER DR. BLDG. B-203
CHARLESTON SC
29414
US

IV. Provider business mailing address

3030 ASHLEY TOWN CENTER DR BLDG. B-203
CHARLESTON SC
29414-5664
US

V. Phone/Fax

Practice location:
  • Phone: 843-642-4964
  • Fax: 843-735-7323
Mailing address:
  • Phone: 843-642-4964
  • Fax: 843-735-7323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4634
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: