MEDICARE: DEANGELIS COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1225929748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEANGELIS COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	4601 BAYARD PARK DR STE D
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0601
Country	:	US
Telephone Number	:	812-807-6050
Fax Number	:	812-437-1702

Provider Business Practice Location Address
First Line	:	4601 BAYARD PARK DR STE D
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47714-0601
Country	:	US
Telephone Number	:	812-807-6050
Fax Number	:	812-437-1702

Authorized Official
Title or Position	:	OWNER
Name	:	RUTH ANN DEANGELIS
Credential	:	LCSW
Telephone Number	:	812-807-6050

Provider Enumeration Date	:	07/12/2025
Last Update Date	:	07/12/2025

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