Angela Moody, L.C.S.W.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

149-005379 Issued in IL

Practice address

208 18TH St
Suite 208
Rock Island, IL 61201-8720

Phone

(309) 799-7044

Fax

(309) 799-7574

NPI assigned

Nov 21, 2014

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 names 1

• Ms. Angela Moody Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Arrowhead Ranch

  dba Arrowhead Youth & Family Services

  • Community/Behavioral Health Agency
  • Rock Island, IL
  • NPI 1972905438
  NPD (past) Authorized official

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1982001707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 104TH ST",
            "city": "COAL VALLEY",
            "state": "IL",
            "postal_code": "612409712",
            "telephone_number": "309-799-7044",
            "fax_number": "309-799-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 18TH ST",
            "address_2": "SUITE 208",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018720",
            "telephone_number": "309-799-7044",
            "fax_number": "309-799-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "ANGELA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149-005379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MOODY",
            "prefix": "MS.",
            "credential": "L.C.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shawna Mitchell, LMSW
• Kylie Jess Monroe, MHP
• Liliana Montelongo, MA
• Kristina Marie Montez, D.C.
• Elizabeth Erin Montgomery
• Elizabeth Moore
• Lekeshia Angelique Moore
• Sarah Jean Moore, LCPM, LM, CPM, BSM
• Michelle Lynn Morgan, QMHP
• Jessica Michelle Morris, CNM

• Mental Health Counselor in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.