Angela Dawn Thomas, MA, LPCC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC04277 Issued in MN

Practice address

516 S Pokegama Ave
Grand Rapids, MN 55744-3820

Phone

(218) 327-2001

NPI assigned

Mar 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeview Behavioral Health IncGroup PAC ID 9537432307, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Lakeview Behavioral Health Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1154404325
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1184482929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 SE 21ST ST APT 305",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442368",
            "telephone_number": "218-910-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S POKEGAMA AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443820",
            "telephone_number": "218-327-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "MA, LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC04277",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC04277",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Emeralds at Grand Rapids Assisted Living LLC
• The Emeralds at Grand Rapids LLC
• The Rock HHC Inc.
• Jean Thom, NP
• Thomas Counseling and Wellness Center LLC
• Cindy Lee Thomas, MSW, LICSW
• Kelli Thompson
• Nicholas Thompson, MS
• Thrifty Drug Stores Inc
• Thrifty Drug Stores, Inc.

• Professional Counselor in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.