Angelica Staten, MS

Primary specialty

Social WorkerTaxonomy code 104100000X

License

17318 Issued in LA

Practice address

617 E Madison Ave
Bastrop, LA 71220-3833

Phone

(318) 239-3890

Fax

(318) 239-3891

NPI assigned

Oct 6, 2015

Last updated

Feb 3, 2023By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Cognitive Development Center Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, LA
  • NPI 1992187322
  NPD (past)

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1891165619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E MADISON AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712203833",
            "telephone_number": "318-239-3890",
            "fax_number": "318-239-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E MADISON AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712203833",
            "telephone_number": "318-239-3890",
            "fax_number": "318-239-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "ANGELICA",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "17318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawanda Smith
• Southern Medical Services of Louisiana, LLC
• Aliciah Kae Souza, B.S.
• Specialty Pharmacy Services Inc
• Yolanda Lafaye Starr, FNP-BC
• Stephenie R. Long, MD LLC
• Sterlington Critical Access Hospital L.L.C (Sterlington Care Clinic)
• Sterlington Critical Access Hospital L.L.C
• Sterlington Critical Access Hospital, L.L.C. (Bastrop Outpatient Rural Health Clinic)
• Sterlington Critical Access Hospital, L.L.C. (Sterlington Rehabilitation Hospital)

• Social Worker in Bastrop, LA
• Providers in Bastrop, LA by specialty
• Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.