Individual provider Active NPI

Angela June Van Sickle, SLP

  • Speech-Language Pathologist
  • Lubbock, TX
National Provider Identifier
1952531345
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
103268 Issued in TX
Practice address
3601 4TH St
Ste. 2A300
Lubbock, TX 79430-0002
Phone
(806) 743-5678
Fax
(806) 743-5670
NPI assigned
Jul 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 103268 TX Primary

Addresses

Primary practice location

3601 4TH St
Ste. 2A300
Lubbock, TX 79430-0002

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address angela.vansicklebednarz1@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915001494 TX Practitioner - Qualified Speech Language Pathologist 0143537753 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103268TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

3601 4th St
#2A300
Lubbock, TX 79430
Phone (806) 743-5678

3601 4th St
Ste 2A300
Lubbock, TX 79430
Phone (806) 743-5678

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1952531345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "STE. 2A300",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-5678",
            "fax_number": "806-743-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SICKLE",
        "first_name": "ANGELA",
        "middle_name": "JUNE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela.vansicklebednarz1@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "address_2": "Ste. 2A300",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.