Active NPI
Angela Willis
- Clinical Social Worker
- Pensacola, FL
National Provider Identifier
1366172124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 23325
- Practice address
- 112 W Cervantes St
Pensacola, FL 32501-3128 - Phone
- (850) 564-6244
- NPI assigned
- Jun 14, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 23325 | FL | Primary |
Addresses
Primary practice location
112 W Cervantes St
Pensacola, FL 32501-3128
Mailing address
112 W Cervantes St
Pensacola, FL 32501-3128
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23325 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1366172124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 W CERVANTES ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325013128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 W CERVANTES ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325013128",
"telephone_number": "850-564-6244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "ANGELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "23325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.