Individual provider Active NPI

Elizabeth Maria Angulo, CDP

  • Addiction (Substance Use Disorder) Counselor
  • Vancouver, WA
National Provider Identifier
1497982821
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP60018150 Issued in WA
Practice address
2009 NE 117TH St Ste 101
Vancouver, WA 98686-4022
Phone
(360) 566-9112
Fax
(360) 566-9133
NPI assigned
Jun 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60018150 WA Primary

Addresses

Primary practice location

2009 NE 117TH St Ste 101
Vancouver, WA 98686-4022

Mailing address

2009 NE 117TH St Ste 101
Vancouver, WA 98686-4022
Phone (360) 566-9112

Other practice location 1

600 Broadway St
Longview, WA 98632-3256
Phone (360) 425-9600

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
CP60018150WAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1497982821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2009 NE 117TH ST STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986864022",
            "telephone_number": "360-566-9112",
            "fax_number": "360-566-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 NE 117TH ST STE 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986864022",
            "telephone_number": "360-566-9112",
            "fax_number": "360-566-9133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986323256",
            "country_code": "US",
            "telephone_number": "360-425-9600",
            "fax_number": "360-425-7282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGULO",
        "first_name": "ELIZABETH",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60018150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.