MEDICARE: ANGELA RICHARDSON LPCA

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	101Y00000X	Counselor	A9679	NC

General Provider Information

NPI Number	:	1881932101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA RICHARDSON LPCA

Provider Business Mailing Address
First Line	:	5315 CHIPSTONE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-2574
Country	:	US
Telephone Number	:	919-747-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	10520 LIGON MILL RD
Second Line	:	SUITE 108
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-4575
Country	:	US
Telephone Number	:	919-263-9592
Fax Number	:	919-263-9670

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

Provider Enumeration Date	:	01/21/2013
Last Update Date	:	01/21/2013

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