Provider Demographics
NPI:1174008700
Name:ABIDE, ANGELA MARCHMAN (LPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARCHMAN
Last Name:ABIDE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 MAYAN WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-2663
Mailing Address - Country:US
Mailing Address - Phone:512-879-7203
Mailing Address - Fax:254-773-0919
Practice Address - Street 1:144 PIERCE AVENUE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2860
Practice Address - Country:US
Practice Address - Phone:478-475-4608
Practice Address - Fax:478-476-8397
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-29
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67319101Y00000X
GA013832101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor