Angela Rae Ullery, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH10354 Issued in FL

Practice address

1601 Big Tree Rd Apt 708
South Daytona, FL 32119-8646

Phone

(386) 847-1509

NPI assigned

Jul 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: angela.ullery.p1@direct.smahealthcare.nextgenshare.com

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1952508871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BIG TREE RD APT 708",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321198646",
            "telephone_number": "386-847-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BIG TREE RD APT 708",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321198646",
            "telephone_number": "386-847-1509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 N Buerkle St",
            "address_purpose": "LOCATION",
            "city": "Stuttgart",
            "state": "AR",
            "postal_code": "721602519",
            "country_code": "US",
            "telephone_number": "281-237-2753",
            "fax_number": "281-644-1846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULLERY",
        "first_name": "ANGELA",
        "middle_name": "RAE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Hal Thompson, APRN
• Shannon M Tonin
• Transformations Hair Salon
• Transformations Mane Focus, Inc.
• Teresa Uhlenhake
• Jaime Van Hyfte
• Kimberly M Van Liempd, PT
• Melody Martin Velosa
• Tameria B Vickers
• Susan Lee Vigo, DR.

• Mental Health Counselor in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.