Angela Christine Elenbaas, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704190660 Issued in MI

Practice address

102 McPherson Ave
Lansing, MI 48915-1760

Phone

(517) 244-8041

Fax

(517) 244-7189

NPI assigned

Mar 9, 2007

Last updated

Dec 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Angela Christine Berg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Recovery Physicians Network of Michigan

  • Addiction (Substance Use Disorder) Psychologist
  • Auburn Hills, MI
  • NPI 1689343683

  Psychiatric/Mental Health

  NPD
• TLC of Mi LLC

  • Nursing Facility/Intermediate Care Facility
  • Brentwood, TN
  • NPI 1174794655
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1225169261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303 S CEDAR ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489113800",
            "telephone_number": "517-887-4467",
            "fax_number": "517-244-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MCPHERSON AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489151760",
            "telephone_number": "517-244-8041",
            "fax_number": "517-244-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELENBAAS",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704190660",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704190660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN AT BEDHD",
            "identifier": "AB190660",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BERG",
            "middle_name": "CHRISTINE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mahdi Elahi
• Kendall Christopher Elam, PHARMACY TECH
• Ala Elayyan, M.D.
• Elctrodiagnostic Medicine Consultants, PLLC
• Megan Eldred
• Elevate Counseling and Community Services, LLC
• Victor A Elgabalawi
• Dalia Elgohary
• Gabriel Elia, MD
• Lee Elisevich

• Psychiatric/Mental Health Nurse Practitioner in Lansing, MI
• Providers in Lansing, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.