NPIMap

Individual provider Active NPI

Angela Marie Pooley, LPC

  • Professional Counselor
  • Adrian, MI
National Provider Identifier
1114266913
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401018807 Issued in MI
Practice address
1040 S Winter St
Suite 1022
Adrian, MI 49221-3876
Phone
(517) 263-8905
NPI assigned
Feb 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 6401018807 MI Primary

Addresses

Primary practice location

1040 S Winter St
Suite 1022
Adrian, MI 49221-3876

Mailing address

1040 S Winter St
Suite 1022
Adrian, MI 49221-3876
Phone (517) 263-8905

Other practice location 1

360 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1214
Phone (616) 805-3660

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

LicenseStateTypeSpecialty
6401018807MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lenawee Community Mental Health Authority Past Accepting new patients
Lenawee Community Mental Health Authority PastSince Oct 1, 2001 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1114266913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "address_2": "SUITE 1022",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "address_2": "SUITE 1022",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 E Beltline Ave NE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495061214",
            "country_code": "US",
            "telephone_number": "616-805-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLEY",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.