Individual provider Active NPI

Angela Cilley, LMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1376973537
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090381 Issued in MI
Practice address
5103 Eastman Ave Ste 117
Midland, MI 48640-6723
Phone
(989) 455-8214
NPI assigned
Nov 25, 2013
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801090381 MI Primary

Addresses

Primary practice location

5103 Eastman Ave Ste 117
Midland, MI 48640-6723

Mailing address

5103 Eastman Ave Ste 117
Midland, MI 48640-6723
Phone (989) 455-8214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20161206001224 MI Practitioner - Clinical Social Worker 9537449772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5103 Eastman Ave
Suite 117
Midland, MI 48640-6723
Phone (989) 455-8214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801090381MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Minds of Michigan Clinical CurrentSince Jun 1, 2023 Accepting new patients

Locations

5103 Eastman Ave
Ste 117
Midland, MI 48640
Phone (989) 455-8214

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1376973537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 EASTMAN AVE STE 117",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406723",
            "telephone_number": "989-455-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 EASTMAN AVE STE 117",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406723",
            "telephone_number": "989-455-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CILLEY",
        "first_name": "ANGELA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.