Angie Ellen Burton, LISW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

I.0009678 Issued in OH

Practice address

7320 State Route 108 Ste a
Wauseon, OH 43567-8201

Phone

(419) 335-3732

NPI assigned

Oct 17, 2007

Last updated

Oct 17, 2007By 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 names 1

• Angie Ellen Wieland Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1376732107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 STATE ROUTE 108 STE A",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435678201",
            "telephone_number": "419-335-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 STATE ROUTE 108 STE A",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435678201",
            "telephone_number": "419-335-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "ANGIE",
        "middle_name": "ELLEN",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.0009678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGIE",
            "last_name": "WIELAND",
            "middle_name": "ELLEN",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• George Boykin Sr.
• Bradley J Adams D P M
• Buckeye Forest at Wauseon LLC (Ayden Healthcare of Wauseon)
• Megan Danee Burkholder
• Nicole Kay Burrows
• Brenda M Byers, LSW
• City of Wauseon (Wauseon Fire Department)
• Anne Clark, LPCC
• Leslie S Clemensen, MD
• Kimberly Sue Clingaman, QMHS

• Mental Health Counselor in Wauseon, OH
• Providers in Wauseon, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.