Susanna P Angelillo, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC00312 Issued in RI

Practice address

2 Regency PLZ Ste 20
Providence, RI 02903-3152

Phone

(401) 837-1285

Fax

(401) 942-4375

NPI assigned

Feb 9, 2007

Last updated

Sep 21, 2015By 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 4

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1548301070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 FLINT AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102514",
            "telephone_number": "401-942-4375",
            "fax_number": "401-942-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 REGENCY PLZ STE 20",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033152",
            "telephone_number": "401-837-1285",
            "fax_number": "401-942-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELILLO",
        "first_name": "SUSANNA",
        "middle_name": "P",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "32284-1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "600052724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "414055",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA65487",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Providence, RI
• Providers in Providence, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.