Provider Demographics
NPI:1144828641
Name:HARP-WITHERSPOON, ANGEL NICOLE (LGPC)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:NICOLE
Last Name:HARP-WITHERSPOON
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 PENTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-4037
Mailing Address - Country:US
Mailing Address - Phone:443-805-8442
Mailing Address - Fax:
Practice Address - Street 1:802 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4212
Practice Address - Country:US
Practice Address - Phone:443-643-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9861101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health