Individual provider Active NPI

Angelique Zimcosky

  • Professional Counselor
  • Knoxville, TN
National Provider Identifier
1831630417
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5367 Issued in TN
Practice address
408 N Cedar Bluff Rd Ste 305
Knoxville, TN 37923-3648
Phone
(865) 888-5818
NPI assigned
Mar 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5367 TN Primary

Addresses

Primary practice location

408 N Cedar Bluff Rd Ste 305
Knoxville, TN 37923-3648

Mailing address

201 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711

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

LicenseStateTypeSpecialty
5367TNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1831630417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175158",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N CEDAR BLUFF RD STE 305",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379233648",
            "telephone_number": "865-888-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMCOSKY",
        "first_name": "ANGELIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.