=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689347379
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA DEE RENEGAR LCMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2021
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 322 8TH AVE E
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28792-3713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-708-7088
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12 LILLIE FARM LN
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28787-0640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-465-8294
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | A16774
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------