Active NPI
Angela Vlies, MSW, LCSW
- Clinical Social Worker
- Green Bay, WI
National Provider Identifier
1699544288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11464
- Practice address
- 2851 University Ave
Green Bay, WI 54311-5855 - Phone
- (920) 851-9811
- NPI assigned
- Dec 25, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 131940 | WI | |
| Clinical Social Worker | 1041C0700X | 11464 | WI | Primary |
Addresses
Primary practice location
2851 University Ave
Green Bay, WI 54311-5855
Mailing address
3360 Heaven Dr
Green Bay, WI 54311-8905
Phone (920) 851-9811
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 |
|---|---|---|---|
| 131940 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703462400000",
"number": "1699544288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3360 HEAVEN DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543118905",
"telephone_number": "920-851-9811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2851 UNIVERSITY AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543115855",
"telephone_number": "920-851-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VLIES",
"first_name": "ANGELA",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-25",
"last_updated": "2023-12-25",
"certification_date": "2023-12-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "131940",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "11464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.