NPIMap

Organization Active NPI

A-Agelopoulos, LLC

  • Clinical Psychologist
  • Shoreline, WA
National Provider Identifier
1508245267
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 60535146 Issued in WA
Legal business name
A-AGELOPOULOS, LLC
Practice address
727 N 182ND Street
Suite 202
Shoreline, WA 98133
Phone
(206) 850-5598
NPI assigned
May 27, 2015
Last updated
Nov 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Authorized official

Name
Angela Elaine Angelopoulos, PSY.D.
Title
Clinical Psychologist
Phone
(206) 850-5598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 60535146 WA Primary

Addresses

Primary practice location

727 N 182ND Street
Suite 202
Shoreline, WA 98133

Mailing address

17944 Fremont Avenue N
Shoreline, WA 98133
Phone (206) 850-5598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251212002167 WA Part B Supplier - Clinic/Group Practice 9931693348 Receives reassigned benefits from 3 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

1107 NE 45th St
Ste 502
Seattle, WA 98105
Phone (206) 785-1953

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1508245267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17944 FREMONT AVENUE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "98133",
            "telephone_number": "206-850-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N 182ND STREET",
            "address_2": "SUITE 202",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "98133",
            "telephone_number": "206-850-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A-AGELOPOULOS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "ANGELOPOULOS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "206-850-5598",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 60535146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.