Angie M Church, LCMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

9140 Issued in NC

Practice address

204 Jefferson St Ste 106
North Wilkesboro, NC 28659-3586

Phone

(336) 838-1644

Fax

(336) 667-7720

NPI assigned

Mar 19, 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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carenet, Inc.

  • Mental Health Counselor
  • Winston Salem, NC
  • NPI 1043424013

  NC

  Medicare reassignment Care Compare group NPD
• Carenet Inc

  • Professional Counselor
  • Winston Salem, NC
  • NPI 1376432492

  Professional

  NPD
• Carenet, Inc.

  • Mental Health Counselor
  • North Wilkesboro, NC
  • NPI 1760696736
  NPD
• Carenet, Inc

  • Professional Counselor
  • Lexington, NC
  • NPI 1659946804

  Professional

  NPD (past)

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carenet Inc 40 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1083989495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 JEFFERSON ST STE 106",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593586",
            "telephone_number": "336-838-1644",
            "fax_number": "336-667-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "ANGIE",
        "middle_name": "M",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "9140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micah Alexander Chapman
• Rebecca Danielle Chapman
• Josephine Cheng, PHARM.D.
• Sireesha Chintapalli
• Christopher E. Roberts, DDS, PA
• Hayden Church
• Zbigniew Cichon, M.D.
• David Grant Clayton, FNP
• Clca Mobility Services LLC
• Nancy Michelle Cleary

• All providers in North Wilkesboro, NC
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.