Angela Bergeron, MS
Individual provider Active NPI Counselor · Paxton, IL
NPI 1699319715 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1699319715
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1510 W Ottawa Rd
Paxton, IL 60957-4090 - Phone
- (217) 379-4302
- Fax
- (217) 817-0379
- NPI assigned
- Oct 31, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire Behavioral Health Services LLC | Past |
Accepting new patients | |
| Community Resource & Counseling Center Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1510 W Ottawa Rd
Paxton, IL 60957-4090
Mailing address
PO Box 162
Paxton, IL 60957-0162
Phone (217) 379-4302
Other providers in Paxton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.