Angel Hardeman

Key facts

NPI

1124777925

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

8117 Ebenezer Church Rd
Raleigh, NC 27612-7307

Phone

(888) 329-4535

NPI assigned

Mar 21, 2022

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 21, 2022.

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1124777925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 CRYSTAL SPRINGS CIR APT 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276176777",
            "telephone_number": "315-751-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8117 EBENEZER CHURCH RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127307",
            "telephone_number": "888-329-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEMAN",
        "first_name": "ANGEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

• Prashanth Haran, M.D.
• Bryce Alan Harbertson, M.D.
• Martha Leigh Harbour, MSW, LCSW
• Cameron Hardee, A.N.P
• Trisha Amber Hardee
• Donna Hardeman, LCSW
• Maureen Ann Harden, DPT
• Paul Burt Harden Jr., MD
• Amanda Hardenbrook, MS, LPC, NCC
• Willis Stanton Hardesty Jr., DDS

All providers in Raleigh, NC · Behavior Technician in North Carolina