Angela Renee Devault, MSW, CMHT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

W9569 Issued in MS

Practice address

2725 Highway 51 S
Hernando, MS 38632-2634

Phone

(662) 449-1971

NPI assigned

Oct 4, 2022

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Region IV Mental Health Services

  dba Timber Hills Mental Health

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537
  NPD (past)

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1750006698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 HIGHWAY 51 S",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386322634",
            "telephone_number": "662-449-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 HIGHWAY 51 S",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386322634",
            "telephone_number": "662-449-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAULT",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "credential": "MSW, CMHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "W9569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela.devault@regionivmhs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2725 Highway 51 S",
            "city": "Hernando",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386322634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Desoto County Board of Supervisors (Desoto County EMS)
• Desoto County Family Dentistry, P.L.L.C.
• Desoto County School District
• Desoto County Schools
• Desoto Family Dental Care,PA
• Katherine Diggs, P.T.
• Chiquaisha Done Strong
• Elizabeth Paige Dougher
• Dr Michael Lyons Proffessional Corporation
• Dr R C Shackelford Optometrist (Shackelford Family Eyecare)

• Clinical Social Worker in Hernando, MS
• Providers in Hernando, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.