ANGEL WILSON (NPI# 1396224010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396224010 |
| Entity Type | Individual |
| Full Name | ANGEL WILSON |
| Credential | CADC #32962 |
| Practice Address |
335 E Wood St Ste B Decatur IL 62523-1431 |
| Practice Telephone | 2174226908 |
| Practice Fax Number | 2174227103 |
| Mailing Telephone | 2174226908 |
| Mailing Fax Number | 2174227103 |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
32962 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861963035 | Angel Wilson | Licensed Practical Nurse | 3440 Skipper St, Lake Charles, LA 70607-7599 | 2018-12-16 |
| 1164430658 | Angel Lee Wilson | Nurse Practitioner | Bia #1 Soldier Creek Rd, Rosebud, SD 57570 | 2006-08-03 |
| 1437493996 | Angel Marie Wilson | Occupational Therapist | 345 E Mulberry St, Lancaster, OH 43130-3166 | 2012-11-21 |
| 1659524668 | Angel Wilson | Social Worker | 5325 Greenwood Ave, Suite 201, West Palm Beach, FL 33407-2452 | 2008-11-04 |
| 1275781544 | Angel Ann-walker Wilson | Internal Medicine | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2008-08-28 |
| Street Address |
335 E WOOD ST STE B |
| City | DECATUR |
| State | IL |
| Zip Code | 62523-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669561080 | Diane S Pleasant | Counselor | 335 E Wood St Ste B, Decatur, IL 62523 | 2006-10-12 |
| 1457846719 | Pleasant Counseling LLC | Case Management | 335 E Wood St Ste B, Decatur, IL 62523-1431 | 2018-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548763238 | Community Health Improvement Center | Clinic/Center | 1027 N Water, Decatur, IL 62523 | 2018-03-09 |
| 1093091597 | Leesa K Reed | Social Worker | 151 N. Main St., Heritage Behavioral Health, Decatur, IL 62523 | 2011-10-27 |
| 1407001357 | Pamela Sue Waterman | Counselor | 720 E. Wood St., Decatur, IL 62523 | 2008-11-19 |
| 1639231731 | Heritage Behavioral Health Center Inc. | Clinic/Center | 151 N Main Street, Decatur, IL 62523 | 2006-12-14 |
| 1376642470 | Gudrun Birgitta Armentrout | Marriage & Family Therapist | 247 West Prairie, Catholics Charities, Decatur, IL 62523 | 2006-09-22 |
| 1871117887 | Restore Wellness Counseling LLC | Social Worker | 106 North Main Street, Decatur, IL 62523 | 2020-06-04 |
| 1275004186 | Stephanie Maurer | Physician Assistant | 320 Central Ave, Decatur, IL 62523 | 2018-12-17 |
| 1174049209 | Patricia Shannon | Licensed Practical Nurse | 151 N Main St, Decatur, IL 62523 | 2017-08-21 |
| 1669673620 | Decatur Public School Dist. #61 | Local Education Agency (LEA) | 101 W Cerro Gordo St, Decatur, IL 62523-1001 | 2007-05-29 |
| 1295246320 | Barbara A Nadler | Speech-Language Pathologist | 101 W Cerro Gordo St, Decatur, IL 62523-1001 | 2017-10-16 |
| Find all providers in zip 62523 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578115564 | Averette Consultation & Therapy, LLC | Counselor | 2789 Lakeview Walk, Decatur, GA 30035-4061 | 2019-07-10 |
| 1972070274 | Lelah Ray | Counselor | 235 N Mill St Ste 800, Decatur, IL 62523-1381 | 2018-10-25 |
| 1821540865 | Heritage Behavioral Health Center | Counselor | 1029 N Water St, Decatur, IL 62523-1022 | 2016-10-25 |
| 1700246709 | Kimberly Moss Wilson | Counselor | 1116 E Ponce De Leon Ave, Decatur, GA 30030-2711 | 2016-03-03 |
| 1053749168 | Matthew Wagner | Counselor | 545 N Mcdonough St Ste 212, Decatur, GA 30030-3310 | 2013-10-29 |
| 1699011155 | Whitney Terree Tyler | Counselor | 3630 Camp Cir Ste 102, Decatur, GA 30032-1304 | 2013-01-02 |
| 1114273315 | Fresh Start Community Developers, LLC | Counselor | 46 Sycamore Sta, Decatur, GA 30030-2757 | 2012-07-25 |
| 1518103662 | Lunye Geter | Counselor | 2799 Lawrenceville Highway, Ste 201, Decatur, GA 30033-2517 | 2008-12-19 |
| 1346416013 | Elaine Rowland Tophia | Counselor | 2283 Waters Run, Decatur, GA 30035-2528 | 2008-05-02 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.