Individual provider Active NPI

Ariel K Peters-Angelucci, LMSW

  • Clinical Social Worker
  • Live Oak, TX
National Provider Identifier
1841910692
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
11901 Toepperwein Rd Ste 1202
Live Oak, TX 78233-3159
Phone
(210) 951-3479
NPI assigned
Aug 31, 2022
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 106039 TX
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

11901 Toepperwein Rd Ste 1202
Live Oak, TX 78233-3159

Mailing address

1000 Diamond Dr Apt 801
Boerne, TX 78006-3022
Phone (210) 573-2851

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
I20240924004721 TX Practitioner - Clinical Social Worker 8022559533 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Eddy Psychotherapy Management, LLC CurrentSince Sep 24, 2024 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Aug 13, 2024 Accepting new patients
Deep Centered Psychiatry PLLC Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

508 Deep Eddy Ave
Austin, TX 78703
Phone (512) 469-0889

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

1922 Dry Creek Way
Ste 108
San Antonio, TX 78259
Phone (512) 887-3993

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": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1841910692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DIAMOND DR APT 801",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063022",
            "telephone_number": "210-573-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 TOEPPERWEIN RD STE 1202",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333159",
            "telephone_number": "210-951-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS-ANGELUCCI",
        "first_name": "ARIEL",
        "middle_name": "K",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "106039",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.