Individual provider Active NPI

Laura Nicole Angel, MA

  • Counselor
  • Elk Grove Village, IL
National Provider Identifier
1215467899
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178013427 Issued in IL
Practice address
1001 Rohlwing Rd
Elk Grove Village, IL 60007
Phone
(847) 524-8800
Fax
(847) 524-8824
NPI assigned
Jun 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Counselor 101Y00000X 178013427 IL Primary

Addresses

Primary practice location

1001 Rohlwing Rd
Elk Grove Village, IL 60007

Mailing address

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone (847) 524-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215002518 IL Practitioner - Mental Health Counselor 3274977483 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178013427ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Young Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

1001 Rohlwing Rd
Elk Grove Vlg, IL 60007

Organizations & group practices 1

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215467899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROHLWING RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073217",
            "telephone_number": "847-524-8800",
            "fax_number": "847-524-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ROHLWING RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "60007",
            "telephone_number": "847-524-8800",
            "fax_number": "847-524-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGEL",
        "first_name": "LAURA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178013427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.