Individual provider Active NPI

Colleen Angel, LPC-IT

  • Professional Counselor
  • Wausau, WI
National Provider Identifier
1649718917
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7927-125 Issued in WI
Practice address
114 Grand Ave
Wausau, WI 54403-6214
Phone
(715) 845-7175
Fax
(715) 845-7142
NPI assigned
Feb 7, 2017
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3399-226 WI
Professional Counselor 101YP2500X 7927-125 WI Primary

Addresses

Primary practice location

114 Grand Ave
Wausau, WI 54403-6214

Mailing address

114 Grand Ave
Wausau, WI 54403-6214
Phone (715) 845-7175

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

LicenseStateTypeSpecialty
3399-226WIMDMental Health Counselor
7927-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elmergreen Associates,LLC PastSince Jul 1, 2015 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1649718917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGEL",
        "first_name": "COLLEEN",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3399-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7927-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.