Angela Montgomery Eells, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4277 Issued in GA

Practice address

111 Dolly St
Gray, GA 31032-5307

Phone

(478) 491-1991

NPI assigned

Dec 24, 2009

Last updated

Dec 24, 2009By 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

Medicare fee-for-service enrollment

Enrolled in GA

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

State licenses

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1578892477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310320818",
            "telephone_number": "478-491-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOLLY ST",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325307",
            "telephone_number": "478-491-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EELLS",
        "first_name": "ANGELA",
        "middle_name": "MONTGOMERY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "4277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Brown Cunningham, RPH
• Josie M Dobson
• Sabine Doirin
• Ashley Danielle Douglas, LMSW
• Dsi Macon, LLC (U.S. Renal Care Gray Dialysis)
• Tory Kirsten Etheridge, NP
• Natalie F Evans, NP-C
• Ga Pain and Behavioral Medicine Inc.
• Marci Gallagher
• Lacy Lee Gardner-Hattaway, OTD, OTR/L, C/NDT

• Clinical Social Worker in Gray, GA
• Providers in Gray, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.