Angela Povletich, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5505-125 Issued in WI

Practice address

5007 S Howell Ave Ste 350
Milwaukee, WI 53207-6159

Phone

(262) 789-1191

NPI assigned

Dec 12, 2013

Last updated

Dec 12, 2019By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.angelapovletich@149809.advancedmd-direct.com

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.

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment NPD
• Healing Corner, LLC

  • Primary Care Clinic/Center
  • Brookfield, WI
  • NPI 1598086928
  NPD (past)

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1326479510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5007 S HOWELL AVE STE 350",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532076159",
            "telephone_number": "262-789-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5007 S HOWELL AVE STE 350",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532076159",
            "telephone_number": "262-789-1191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4040 N Calhoun Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530051341",
            "country_code": "US",
            "telephone_number": "262-781-0240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POVLETICH",
        "first_name": "ANGELA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5505-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42170300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Pottinger, BCABA
• Leah Poulos, MD
• Michael Poulson, MD
• Gregory A. Poulton, PA-C
• Pedram Pourhosseini
• Matthew Povlich, NP
• Ruth M Povlich, PA-C
• Rhea Powell Hargraves
• Guy Robert Powell, M.D.
• Heather Ann Powell, PHARMD

• Professional Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.