Active NPI
Angella K Jernigan, LPC
- Professional Counselor
- Birmingham, AL
National Provider Identifier
1851424683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C1331A
- Practice address
- 4898 Valleydale Rd
Suite B-4
Birmingham, AL 35242-4654 - Phone
- (205) 538-4710
- Fax
- (205) 991-7226
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C1331A | AL | Primary |
Addresses
Primary practice location
4898 Valleydale Rd
Suite B-4
Birmingham, AL 35242-4654
Mailing address
PO Box 19982
Birmingham, AL 35219-0982
Phone (205) 538-4710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 24, 2024 through May 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1331A | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332979200000",
"number": "1851424683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19982",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352190982",
"telephone_number": "205-538-4710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4898 VALLEYDALE RD",
"address_2": "SUITE B-4",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352424654",
"telephone_number": "205-538-4710",
"fax_number": "205-991-7226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JERNIGAN",
"first_name": "ANGELLA",
"middle_name": "K",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2012-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "C1331A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.