Individual provider Active NPI

Angela Karen Bridges, M.S.W., L.C.S.W

  • Clinical Social Worker
  • Wake Forest, NC
National Provider Identifier
1053560755
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C006038 Issued in NC
Practice address
7304 Mithrasdowne CT
Wake Forest, NC 27587-5396
Phone
(919) 671-3317
Fax
(919) 761-1244
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C006038 NC Primary

Addresses

Primary practice location

7304 Mithrasdowne CT
Wake Forest, NC 27587-5396

Mailing address

7304 Mithrasdowne CT
Wake Forest, NC 27587-5396
Phone (919) 671-3317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C006038NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1053560755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7304 MITHRASDOWNE CT",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875396",
            "telephone_number": "919-671-3317",
            "fax_number": "919-761-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7304 MITHRASDOWNE CT",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875396",
            "telephone_number": "919-671-3317",
            "fax_number": "919-761-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "ANGELA",
        "middle_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "M.S.W., L.C.S.W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.