Angela Wall Mauldin, LCSW

Individual provider Active NPI Clinical Social Worker · Harmony, NC

NPI 1013944644 · NPPES record last updated Feb 6, 2023

Key facts

NPI
1013944644
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C004358 (NC)
Practice address
239 Homestead Rd
Harmony, NC 28634-9448
Phone
(704) 928-7360
Fax
(704) 919-5731
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 11, 2024 through Jan 11, 2028

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C004358NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
In the Garden Counseling, PLLC Current
since Feb 12, 2023
Accepting new patients

Locations

239 Homestead Rd
Harmony, NC 28634
Phone (704) 928-7360

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C004358 NC Yes

Addresses

Primary practice location

239 Homestead Rd
Harmony, NC 28634-9448

Mailing address

239 Homestead Rd
Harmony, NC 28634-9448
Phone (704) 928-7360

Other providers in Harmony, NC

All providers in Harmony, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.