NPIMap

Organization Active NPI

Angelic Health Practice Group

Doing business as Angelic Behavioral Health of NJ

  • Clinical Social Worker
  • Pleasantville, NJ
National Provider Identifier
1639867864
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ANGELIC HEALTH PRACTICE GROUP
Doing business as
Angelic Behavioral Health of NJ
Practice address
8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone
(844) 929-0225
Fax
(609) 822-7980
NPI assigned
Apr 26, 2023
Last updated
Apr 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ANGELIC HEALTH PRACTICE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Dan Mikus
Title
Ceo
Phone
(609) 822-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967

Mailing address

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone (844) 929-0225

Other names 1

  • Angelic Behavioral Health of NJ Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240123001751 NJ Part B Supplier - Clinic/Group Practice 9537510938 Receives reassigned benefits from 8 practitioners
4 other NPIs on this enrollment
Practice locations: Pleasantville, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Angelic Palliative Care PA8 organizations share this tax ID, including this one
Part of
Angelic Palliative Care PA

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1639867864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "844-929-0225",
            "fax_number": "609-822-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 BLACK HORSE PIKE STE 501",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322967",
            "telephone_number": "844-929-0225",
            "fax_number": "609-822-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELIC HEALTH PRACTICE GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANGELIC HEALTH PRACTICE GROUP",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "MIKUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-822-7979"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angelic Behavioral Health of NJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pleasantville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.