Individual provider Active NPI

Angela Collins, LCSW

  • Clinical Social Worker
  • Ennis, TX
National Provider Identifier
1740989953
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103566 Issued in TX
Practice address
107 E Martin Luther King Dr
Ennis, TX 75119-2501
Phone
(214) 664-5391
NPI assigned
Feb 27, 2023
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 103566 TX
Clinical Social Worker 1041C0700X 103566 TX Primary

Addresses

Primary practice location

107 E Martin Luther King Dr
Ennis, TX 75119-2501

Mailing address

1410 Munn Dr
Ennis, TX 75119-2224
Phone (214) 672-3393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212003194 TX Practitioner - Clinical Social Worker 4385174838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103566TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Single Specialty CurrentSince Feb 11, 2025 Accepting new patients
Ellis County Coalition for Health Options PastSince Mar 1, 2023 Accepting new patients
Ellis County Coalition for Health Options Single Specialty PastSince Mar 1, 2023 Accepting new patients

Locations

600 Congress Ave
Austin, TX 78701
Phone (281) 330-3059

Organizations & group practices 3

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1740989953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 MUNN DR",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751192224",
            "telephone_number": "214-672-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E MARTIN LUTHER KING DR",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751192501",
            "telephone_number": "214-664-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ANGELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "103566",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "103566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ennis, TX

Sources for this page

Verify at the official NPI Registry.