Active NPI
Angella Bramwell
- Mental Health Counselor
- Lawrenceville, GA
National Provider Identifier
1013255116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CSW002446
- Practice address
- 175 Gwinnett Dr
Lawrenceville, GA 30046-8444 - Phone
- (770) 339-2395
- Fax
- (678) 990-3997
- NPI assigned
- Jan 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CSW002446 | GA | Primary |
Addresses
Primary practice location
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Mailing address
4202 Colony East Dr
Stone Mountain, GA 30083-5414
Phone (404) 717-9263
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00809696A | Medicaid | GA | |
| 008096968 | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW002446 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358985600000",
"number": "1013255116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4202 COLONY EAST DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300835414",
"telephone_number": "404-717-9263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 GWINNETT DR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468444",
"telephone_number": "770-339-2395",
"fax_number": "678-990-3997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAMWELL",
"first_name": "ANGELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-24",
"last_updated": "2013-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "CSW002446",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00809696A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008096968",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.