Angelina Michelle Skiles, LICENSED CLINICAL SO

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0000004680 Issued in TN

Practice address

Corner of West Market and Lamont Street
Johnson City, TN 37601

Phone

(423) 979-2675

NPI assigned

Jul 10, 2006

Last updated

Sep 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Angelina Michelle Walsh Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1467486324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 EASTLAND DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376435501",
            "telephone_number": "423-979-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF WEST MARKET AND LAMONT STREET",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-979-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILES",
        "first_name": "ANGELINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LICENSED CLINICAL SO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "0000004680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMSW",
            "identifier": "0000004680",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELINA",
            "last_name": "WALSH",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "LICENSED CLINICAL SO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dana Bates Skaggs, M.A.
• Michael Paul Skeen, NP-C
• Ashley Skelton, N.P.
• Tyler Blake Skelton, RN
• Destiny Cheyenne Skidmore
• Shauna Skinner, SLP
• Skinwise PLLC
• Sleep Apnea Associates
• Olga Slonopas, PHARM.D.
• Rachel Miller Slough, PHD

• Clinical Social Worker in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.