Angela Charley, LPCC, ATR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3845 Issued in MN

Practice address

4820 W 77TH St Ste 130
Edina, MN 55435-4832

Phone

(651) 313-8080

NPI assigned

Sep 12, 2023

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1548047558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 W 77TH ST STE 130",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W 77TH ST STE 130",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354832",
            "telephone_number": "651-313-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLEY",
        "first_name": "ANGELA",
        "credential": "LPCC, ATR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "3845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Chan
• John Kingsley Chang, M.D
• Scott Chang, M.D.
• Norman Chapel, M.D.
• Marisa A Chapman, M.D.
• Shivan Charran, OTR/L
• Andre Chartier, M.D.
• Geraldine Chavis, MA
• Kenneth Marshall Chavis, PH.D.
• Puja Bharucha Chawla, MD

• All providers in Edina, MN
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.