Individual provider Active NPI

Angela Taylor Shield, LCPC

  • Professional Counselor
  • Wheaton, IL
National Provider Identifier
1356300404
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180005724 Issued in IL
Practice address
7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2039
Phone
(630) 653-2300
Fax
(630) 653-2895
NPI assigned
Mar 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180005724 IL Primary

Addresses

Primary practice location

7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2039

Mailing address

7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2039
Phone (630) 653-2300

Other identifiers 1

IdentifierTypeStateIssuer
02215643OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180005724ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Clinical Associates SC Professional PastSince Mar 1, 2000 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1356300404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 201",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892039",
            "telephone_number": "630-653-2300",
            "fax_number": "630-653-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 201",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892039",
            "telephone_number": "630-653-2300",
            "fax_number": "630-653-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELD",
        "first_name": "ANGELA",
        "middle_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02215643",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.