Active NPI
Angela M Bross, LPC
- Counselor
- Avinger, TX
National Provider Identifier
1275060469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 74360
- Practice address
- 355 Church Street
Avinger, TX 75630 - Phone
- (318) 505-2281
- NPI assigned
- May 18, 2017
- Last updated
- May 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 74360 | TX | Primary |
Addresses
Primary practice location
355 Church Street
Avinger, TX 75630
Mailing address
355 Church Street
Avinger, TX 75630
Phone (318) 505-2281
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74630 | Other | TX | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- 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: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495065600000",
"number": "1275060469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 CHURCH STREET",
"city": "AVINGER",
"state": "TX",
"postal_code": "75630",
"telephone_number": "318-505-2281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 CHURCH STREET",
"city": "AVINGER",
"state": "TX",
"postal_code": "75630",
"telephone_number": "318-505-2281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROSS",
"first_name": "ANGELA",
"middle_name": "M",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-18",
"last_updated": "2017-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "74360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "74630",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avinger, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; 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.