MS. ANGELA TELLEZ (NPI# 1154828424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154828424 |
| Entity Type | Individual |
| Full Name | MS. ANGELA TELLEZ |
| Credential | QMHS |
| Practice Address |
1045 Klotz Rd Bowling Green OH 43402-4820 |
| Practice Telephone | 4198891316 |
| Mailing Telephone | 4193527588 |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2018-04-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790249316 | Angela Lynn Tellez | Social Worker | 755 S Telshor Blvd Ste 201b, Las Cruces, NM 88011-3647 | 2019-01-28 |
| Street Address |
1045 KLOTZ RD |
| City | BOWLING GREEN |
| State | OH |
| Zip Code | 43402-4820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912992496 | Jeffrey W Wahl | Psychiatry & Neurology | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2005-09-12 |
| 1467050070 | Leann Niccole Mcgraw | Social Worker | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2020-10-15 |
| 1508463514 | Mark Anthony Johnson Jr. | Social Worker | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2020-10-02 |
| 1841804705 | Joseph Stockton | Social Worker | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2020-09-08 |
| 1053925362 | Astasha Perrine | Counselor | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2020-09-03 |
| 1902430721 | Kimberly C Molnar | Counselor | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2020-03-02 |
| 1003452350 | Tess J Lohse | Social Worker | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2019-11-21 |
| 1962047019 | Tabatha Marie Miller | Social Worker | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2019-11-13 |
| 1629612031 | Emily Perkins | Community/Behavioral Health | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2019-10-30 |
| 1477196442 | Kelsey Morgan Parker | Social Worker | 1045 Klotz Rd, Bowling Green, OH 43402-4820 | 2019-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316592017 | Danielle Urbaniak | Pharmacist | 722-740 South Main St, Bowling Green, OH 43402 | 2019-08-08 |
| 1013485648 | Julie Marie Knapp | Counselor | 219 South Church Street, Bowling Green, OH 43402 | 2018-11-13 |
| 1477065274 | Elizabeth Marie Leber | Social Worker | 1045 Klotz Rd., Bowling Green, OH 43402 | 2017-11-02 |
| 1558871913 | Genoa Healthcare, LLC | Pharmacy | 1010 N Prospect St Ste 56, Bowling Green, OH 43402 | 2017-10-11 |
| 1093224933 | Kevin Wagner | Contractor | 19644 Hull Prairie Rd, Bowling Green, OH 43402 | 2017-09-22 |
| 1487102273 | Mary Ann Bostdorff | Registered Nurse | 1011 North Prospect St., Bowling Green, OH 43402 | 2016-09-21 |
| 1174927354 | Kristy Siegle | Counselor | 1010 North Prospect, Bowling Green, OH 43402 | 2014-10-16 |
| 1366846560 | Timothy M Burkart | Pharmacist | 1840 E. Gypsy Lane Rd, (wood County Health Department), Bowling Green, OH 43402 | 2014-10-16 |
| 1144629411 | Ledeithra Denise Mckinney | Speech-Language Pathologist | 1921 East Gypsy Lane Rd., Bowling Green, OH 43402 | 2014-08-22 |
| 1558701607 | Mark Joseph Kleeberger | Physical Therapy Assistant | 1180 N Main St, Bowling Green, OH 43402 | 2013-07-02 |
| Find all providers in zip 43402 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235677592 | Jocelyn Wilson | Residential Treatment Facility, Emotionally Disturbed Children | 182 Midlothian Ave, Youngstown, OH 44507 | 2017-02-07 |
| 1912311937 | Katina Nichols | Residential Treatment Facility, Emotionally Disturbed Children | 2645 Blue Heron Dr, Hudson, OH 44236-1868 | 2014-06-18 |
| 1912223157 | The Center for Child&family Development | Residential Treatment Facility, Emotionally Disturbed Children | 1930 Maple Ave, Zanesville, OH 43701-2238 | 2010-04-13 |
| 1619097052 | Redemption, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 11780 Western Reserve Rd, Salem, OH 44460-7619 | 2007-03-30 |
| 1699899864 | Charles Lamont Hankton | Residential Treatment Facility, Emotionally Disturbed Children | 5593 Carlton Dr, Bedford Hts, OH 44146-2329 | 2007-03-16 |
| 1548288350 | Talbert House | Residential Treatment Facility, Emotionally Disturbed Children | 9018 Cincinnati Columbus Rd, West Chester, OH 45069-3565 | 2006-07-18 |
| 1245262799 | Lutheran Homes Society, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1905 Perrysburg Holland Rd, Holland, OH 43528-9582 | 2006-07-07 |
| 1578528014 | Rosemont Center | Residential Treatment Facility, Emotionally Disturbed Children | 2440 Dawnlight Ave, Columbus, OH 43211-1934 | 2006-04-18 |
| 1740244284 | Oesterlen Services for Youth, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1918 Mechanicsburg Rd, Springfield, OH 45503-3147 | 2006-04-13 |
| 1184687030 | Oak Ridge Treatment Center Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 115 Private Road 977 County Road 44 North, Pedro, OH 45659 | 2006-04-11 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 43402 |
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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.