Angela Marie Johns, CADC

Key facts

NPI

1679747711

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

25871 (IL)

Practice address

555 Fairview Dr # DRQ
Rochelle, IL 61068-2310

Phone

(815) 502-9003

NPI assigned

Apr 19, 2008

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2008.

{
    "created_epoch": "1208563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208563200000",
    "number": "1679747711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 MANESS CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601782910",
            "telephone_number": "815-501-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 FAIRVIEW DR # DRQ",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610682310",
            "telephone_number": "815-502-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-19",
        "last_updated": "2008-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "25871",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Rochelle, IL · Addiction (Substance Use Disorder) Counselor in Illinois