Organization Active NPI

Arch Angel Services

  • Mental Health Counselor
  • Columbus, OH
National Provider Identifier
1093453615
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ARCH ANGEL SERVICES
Practice address
4182 Worth Ave Ste 1-115
Columbus, OH 43219-1535
Phone
(312) 474-6189
NPI assigned
May 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Authorized official

Name
Antuan Durall Wilbon
Title
Ceo/Owner
Phone
(708) 743-2608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4182 Worth Ave Ste 1-115
Columbus, OH 43219-1535

Mailing address

20 S 3Rd St Ste 210
Columbus, OH 43215-4206
Phone (833) 427-2264

Other practice location 1

20 S 3rd St Ste 210
Columbus, OH 43215-4206
Phone (833) 427-2264

Other identifiers 1

IdentifierTypeStateIssuer
17014MedicaidIL

National Provider Directory

National Provider Directory

Locations

4182 Worth Ave
Ste 1115
Columbus, OH 43219
Phone (312) 474-6189

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1093453615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 S 3RD ST STE 210",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154206",
            "telephone_number": "833-427-2264",
            "fax_number": "773-260-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4182 WORTH AVE STE 1-115",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191535",
            "telephone_number": "312-474-6189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 S 3rd St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154206",
            "country_code": "US",
            "telephone_number": "833-427-2264",
            "fax_number": "773-260-1479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARCH ANGEL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "WILBON",
        "authorized_official_first_name": "ANTUAN",
        "authorized_official_middle_name": "DURALL",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "708-743-2608"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17014",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.