Angel'S Place LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ANGEL'S PLACE LLC

Practice address

939 Baxter Ave
Louisville, KY 40204-2046

Phone

(812) 660-9936

NPI assigned

Dec 3, 2024

Organization subpart

No

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

Authorized official

Name

Michael Montez Percell

Title

Owner

Phone

(502) 356-6035

Specialties & licenses 1

Addresses

Other names 1

• CSP Recovery Services Doing business as

Locations

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1265258446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 LOUIS COLEMAN JR DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402112952",
            "telephone_number": "502-356-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402042046",
            "telephone_number": "812-660-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL'S PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "PERCELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "MONTEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-356-6035"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSP Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.