ROY LEE ANGEL JR. (NPI# 1013482728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013482728 |
| Entity Type | Individual |
| Full Name | ROY LEE ANGEL JR. |
| Practice Address |
704 Emmet St Petoskey MI 49770-2910 |
| Practice Telephone | 2313475511 |
| Practice Fax Number | 2313475422 |
| Mailing Telephone | 2313475511 |
| Mailing Fax Number | 2313475422 |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
704 EMMET ST |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962551648 | Harbor Hall, Inc. | Clinic/Center | 704 Emmet St, Petoskey, MI 49770-2910 | 2007-01-10 |
| 1447866330 | Jennifer Boop | Nurse Practitioner | 704 Emmet St, Petoskey, MI 49770-2910 | 2020-09-16 |
| 1760004907 | Brandon Robert Peter Mielke | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2020-05-11 |
| 1508413964 | Ralph Godmar | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2019-08-21 |
| 1780237602 | Teresa Peterson | Social Worker | 704 Emmet St, Petoskey, MI 49770-2910 | 2019-07-19 |
| 1548739238 | Angel Herriman | Social Worker | 704 Emmet St, Petoskey, MI 49770-2910 | 2018-11-26 |
| 1922581669 | Kasey Ann Olesak | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2018-09-10 |
| 1669976189 | Cooper Brubacher | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2018-03-20 |
| 1528591518 | Janice Barlow | Registered Nurse | 704 Emmet St, Petoskey, MI 49770-2910 | 2017-04-06 |
| 1336681352 | Theresa Van Fleet | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2016-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
| Find all providers in zip 49770 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004907 | Brandon Robert Peter Mielke | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2020-05-11 |
| 1285129742 | William Hyatt Carter | Counselor | 2236 E Mitchell Rd Unit 5, Petoskey, MI 49770-9604 | 2018-06-27 |
| 1326530247 | Lee Martin Rousseau | Counselor | 2236 E Mitchell Rd Unit 5, Petoskey, MI 49770-9604 | 2018-06-06 |
| 1669976189 | Cooper Brubacher | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2018-03-20 |
| 1336681352 | Theresa Van Fleet | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2016-11-08 |
| 1558803627 | Paula Musilek | Counselor | 2236 E Mitchell Rd, Petoskey, MI 49770-9604 | 2016-11-07 |
| 1932641057 | John Patrick Doody | Counselor | 704 Emmet St, Petoskey, MI 49770-2910 | 2016-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434669 | Great-lakes Restorative Counseling, LLC | Counselor | 11800 Merriman Rd Unit 510896, Livonia, MI 48151-2075 | 2020-10-16 |
| 1386251841 | Diversified Community Services | Counselor | 10301 W 7 Mile Rd, Detroit, MI 48221-1962 | 2020-09-29 |
| 1891302717 | Paige J Welch | Counselor | 1509 Diamond Ave Ne, Grand Rapids, MI 49505-5217 | 2020-09-24 |
| 1588277040 | Gregory Dean Retzlaff | Counselor | 2043 Rowe Ave Ne, Grand Rapids, MI 49505-4238 | 2020-08-25 |
| 1336759539 | Embodied Wellness, Pllc | Counselor | 1354 Harvard Rd, Berkley, MI 48072 | 2020-08-03 |
| 1164030136 | Amina Mcclendon | Counselor | 22190 Avon Rd, Oak Park, MI 48237-2572 | 2020-07-16 |
| 1134747835 | Janita E Deal | Counselor | 503 Pearl St Ste 7, Ypsilanti, MI 48197-2615 | 2020-07-09 |
| 1376160168 | Scott Thomas Montgomery | Counselor | 1242 Baywood Cir, Brighton, MI 48116-6761 | 2020-06-29 |
| 1750907853 | Ronnie Stephen | Counselor | 15025 Fenkell St, Detroit, MI 48227-2647 | 2020-06-24 |
| 1043833643 | Ralph Cunningham | Counselor | 16057 Blue Star M Hwy, South Haven, MI 49090-9470 | 2020-05-19 |
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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.