NPIMap

Organization Active NPI

Angelic Health Practice Group

Doing business as Angelic Behavioral Health of PA

  • Clinical Social Worker
  • Blue Bell, PA
National Provider Identifier
1194413336
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ANGELIC HEALTH PRACTICE GROUP
Doing business as
Angelic Behavioral Health of PA
Practice address
486 Norristown Rd Ste 133B
Blue Bell, PA 19422-2353
Phone
(267) 995-4086
Fax
(267) 285-4391
NPI assigned
Apr 26, 2023
Last updated
Apr 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ANGELIC HEALTH PRACTICE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Dan Mikus
Title
Ceo
Phone
(609) 822-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

486 Norristown Rd Ste 133B
Blue Bell, PA 19422-2353

Mailing address

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone (098) 227-9796

Other names 1

  • Angelic Behavioral Health of PA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240214004082 PA Part B Supplier - Clinic/Group Practice 9537510938 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blue Bell, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Angelic Palliative Care PA8 organizations share this tax ID, including this one
Part of
Angelic Palliative Care PA

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1194413336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "098-227-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 NORRISTOWN RD STE 133B",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222353",
            "telephone_number": "267-995-4086",
            "fax_number": "267-285-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC HEALTH PRACTICE GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANGELIC HEALTH PRACTICE GROUP",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "MIKUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-822-7979"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angelic Behavioral Health of PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.