Individual provider Active NPI

Angellicia Vanessa D'Anjou, LIAC

  • Addiction (Substance Use Disorder) Counselor
  • Goodyear, AZ
National Provider Identifier
1750259453
Registry record updated Oct 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LIAC-155378 Issued in AZ
Practice address
15679 W Montecito Ave
Goodyear, AZ 85395-7786
Phone
(623) 337-6274
NPI assigned
Oct 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LIAC-155378 AZ Primary

Addresses

Primary practice location

15679 W Montecito Ave
Goodyear, AZ 85395-7786

Mailing address

15679 W Montecito Ave
Goodyear, AZ 85395-7786
Phone (623) 337-6760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260610004735 AZ Practitioner - Mental Health Counselor 7618449661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15679 W Montecito Ave
Goodyear, AZ 85395-7786

3450 N 3Rd St
Phoenix, AZ 85012-2331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LIAC-155378AZMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
My Therapy Health LLC Addiction (Substance Use Disorder) CurrentSince Nov 9, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761350400000",
    "number": "1750259453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15679 W MONTECITO AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957786",
            "telephone_number": "623-337-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15679 W MONTECITO AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957786",
            "telephone_number": "623-337-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANJOU",
        "first_name": "ANGELLICIA",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "LIAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-25",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-155378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.