MEDICARE: ANGELA E HENDERSON BS, CPSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	M2024-12866-01	NC
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1003763764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA E HENDERSON BS, CPSS

Provider Business Mailing Address
First Line	:	6591 BROOKSHIRE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-5115
Country	:	US
Telephone Number	:	910-490-8309
Fax Number	:

Provider Business Practice Location Address
First Line	:	6591 BROOKSHIRE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-5115
Country	:	US
Telephone Number	:	910-490-8309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

Similar Medicare Providers

1447106752 — DANA TABB
Practice Location Address:

6885 CLIFFDALE RD STE 202
FAYETTEVILLE, NC
28314-2834

Practice Phone: 910-339-0400
Practice Fax: 910-339-0396

1811843964 — ESTELLE A WALKER
Practice Location Address:

1916 SKIBO RD STE 101
FAYETTEVILLE, NC
28314-1526

Practice Phone: 571-344-2177
Practice Fax:

1598611642 — EXTELLE HAIR STUDIO
Practice Location Address:

1916 SKIBO RD STE 101
FAYETTEVILLE, NC
28314-1526

Practice Phone: 571-344-2177
Practice Fax:

1033066055 — NOAH DUSTIN STAMP
Practice Location Address:

5135 MORGANTON RD STE 101
FAYETTEVILLE, NC
28314-1525

Practice Phone: 910-551-1670
Practice Fax:

1821545005 — WENDY T BARTLEY PT
Practice Location Address:

4140 FERNCREEK DR , SUITE 801
FAYETTEVILLE, NC
28314-2563

Practice Phone: 910-484-2171
Practice Fax:

1972023497 — DR. MARYSELLE WINTERS DO
Practice Location Address:

4140 FERNCREEK DR STE 601
FAYETTEVILLE, NC
28314-2569

Practice Phone: 910-485-3880
Practice Fax: 910-485-5341

Directions to “ ANGELA E HENDERSON BS, CPSS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.