Angelo Gilmore, LMSW, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401000319 Issued in MI

Practice address

4512 Dixie Hwy
Waterford, MI 48329-3514

Phone

(248) 909-1869

Fax

(248) 599-7392

NPI assigned

Feb 10, 2022

Last updated

Feb 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genuine Solutions Counseling Center

  • Substance Abuse Rehabilitation Facility
  • Waterford, MI
  • NPI 1588979876

  Professional

  Medicare reassignment NPD
• Therapy Services of Clarkston

  • Clinic/Center
  • Clarkston, MI
  • NPI 1497399745
  Medicare reassignment NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1881348589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 VIRGINIA PARK ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022037",
            "telephone_number": "313-559-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293514",
            "telephone_number": "248-909-1869",
            "fax_number": "248-599-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "ANGELO",
        "credential": "LMSW, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401000319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby Joe Gibbs, BA,, FADOP
• James Arthur Gibson, M.D.
• Mikayla Danielle Gilkerson
• April Renae Gilliard-Garner, RN
• Annette R Gilliland, MSW
• Gina Gora M D PLLC
• Spencer Gines
• Blake Glanton
• Libbie Gleason
• Christine Glowacki, FNP BC

• Professional Counselor in Waterford, MI
• Providers in Waterford, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.