ANGELL Y MACK (NPI# 1346899499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346899499 |
| Entity Type | Individual |
| Full Name | ANGELL Y MACK |
| Credential | CADC |
| Practice Address |
620 N Walnut St Springfield IL 62702-4930 |
| Practice Telephone | 2175444631 |
| Mailing Telephone | 2175444631 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| 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 |
620 N WALNUT ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700438678 | Julie Ann Blythe | Counselor | 620 N Walnut St, Springfield, IL 62702-4930 | 2019-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803990 | Stephanie R Stephens | Counselor | 1705 Maiden Ln, Springfield, OH 45504-2908 | 2020-02-14 |
| 1801449988 | Maurice Steven Martinez | Counselor | 7215 Adrienne Glen Ave, Springfield, VA 22152-3540 | 2019-07-18 |
| 1215494737 | John Henry Mccollum Jr. | Counselor | 80 Congress St Ste 101, Springfield, MA 01104-3427 | 2019-02-21 |
| 1821584541 | Patricia Thakur | Counselor | 404 E Battlefield St # R, Springfield, MO 65807-4802 | 2018-07-05 |
| 1336632074 | Solutions Group Nw LLC | Counselor | 3831 Main St Ste 108, Springfield, OR 97478-5801 | 2018-06-07 |
| 1285126235 | Rebecca Ann Dalton | Counselor | 3032 S Fremont Ave Ste C200, Springfield, MO 65804-4210 | 2018-06-05 |
| 1184136905 | Mark Jones | Counselor | 120 N Fountain Ave, Springfield, OH 45502-1163 | 2017-11-02 |
| 1457863599 | Michael A Carter | Counselor | 832 Olive St, Springfield, OH 45503-3738 | 2017-10-30 |
| 1710498001 | Springfield Treatment Center | Counselor | 1485 Market St, Springfield, OR 97477-3337 | 2017-10-13 |
| 1740702547 | Domingo Nieves Jr. | Counselor | 2225 Main St., Springfield, MA 01107 | 2017-07-13 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on ANGELL Y MACK.
| 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.