Kimberly J D Angelo, MC 61115650

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61115650 Issued in WA

Practice address

15446 Bel Red Rd Ste 200
Redmond, WA 98052-5517

Phone

(425) 295-7697

NPI assigned

May 10, 2022

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1104562396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 222ND PL SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214220",
            "telephone_number": "206-830-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15446 BEL RED RD STE 200",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525517",
            "telephone_number": "425-295-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D ANGELO",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "MC 61115650",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61115650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Crown, PT, DPT
• Rose Ann Cruse, OT
• Vina Sadang Cruz, D.O.
• Xiaojuan Cui, DDS
• Amber M Cumings, OD
• Anna Maria D'Urso
• Daciana Buse DDS, MSD, PLLC
• Rachel Louise Dahl, MSW, LSWAIC
• Aveed Dai Ali Akbar, NP
• Jialin Dai

• Mental Health Counselor in Redmond, WA
• Providers in Redmond, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.