Angela Denise Colville, MSW, LCSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

149013723 Issued in IL

Practice address

1739 N Wilmot Ave
Chicago, IL 60647-5523

Phone

(773) 269-9400

Fax

(269) 912-5925

NPI assigned

Jan 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Colville Counseling, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1891124210
  NPD (past) Authorized official

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1063782423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 N WILMOT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475523",
            "telephone_number": "773-269-9400",
            "fax_number": "269-912-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 N WILMOT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475523",
            "telephone_number": "773-269-9400",
            "fax_number": "269-912-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVILLE",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "149013723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Columbia Furniture
• Columbus Manor
• Shamel Colvard
• Colvel Labs Inc.
• Colville Counseling, LLC
• Anquinette Colvin, REGISTERED NURSE
• Wallace Sprugeon Colvin IV, MA
• Janice C. Colwell, RN,MS,CWOCN
• Lamar Colyer III, LCPC
• Youssef G Comair, M.D.

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.

Verify at the official NPI Registry.