Active NPI
Nancy L. Deangelis, CASAC
- Mental Health Counselor
- Utica, NY
National Provider Identifier
1609058205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11580
- Practice address
- 1427 Genesee St
Utica, NY 13501-4343 - Phone
- (315) 738-1428
- Fax
- (315) 738-1461
- NPI assigned
- Dec 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11580 | NY | Primary |
Addresses
Primary practice location
1427 Genesee St
Utica, NY 13501-4343
Mailing address
1020 Mary St
Utica, NY 13501-1930
Phone (315) 724-6072
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01039156 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11580 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221696000000",
"number": "1609058205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 MARY ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135011930",
"telephone_number": "315-724-6072",
"fax_number": "315-733-0791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1427 GENESEE ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135014343",
"telephone_number": "315-738-1428",
"fax_number": "315-738-1461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEANGELIS",
"first_name": "NANCY",
"middle_name": "L.",
"credential": "CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-05",
"last_updated": "2008-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "11580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01039156",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.