DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) – Professional Counselor, NPI 1770868234

DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) is a healthcare provider. based in Russell springs, Kentucky. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials NCC CCMHC CHT LPCC-S. They hold a License No. 103409 (KY). The NPI Number for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) is 1770868234

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S)
NPI
1770868234
Phone
(270) 866-4753
Address
2976 HIGHWAY 910
Enumeration Date
17 October 2011
Last Update Date
23 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2708610606
Graduation Year
2015 (11 years ago)
PAC ID
4284072299
Group Practice PAC ID
7416298948
Professional Enrollment ID
I20240409003687
Address ID
KY421412604GL100XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:14State licenses:2Digital endpointsOther names

862 MENTAL HEALTH COUNSELOR in KY

Provider Addresses for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S)

  • 2976 HIGHWAY 910

    SUITE B

    RUSSELL SPRINGS, KY 426428963

    Phone: (270) 866-4753

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-04-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240409003687IMental Health CounselorKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42642)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416298948View full group profile
NameSpecialtyState
Mental Health CounselorKY
Mental Health CounselorKY
Mental Health CounselorKY
Nurse PractitionerKY
Nurse PractitionerKY
Mental Health CounselorKY
Nurse PractitionerKY

Reviews

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Frequently asked questions

Is there an official ID for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) in U.S. healthcare records?
The official identifier for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) is NPI 1770868234.
Is DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) shown as active in public data?
Registry records indicate DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) maintains an active NPI.
What clinical focus is listed for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S)?
At a glance, DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S) is tied to Professional Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S)?
Travel planning: use Russell Springs, Kentucky as the reference point for DR. ANGELIA SHAW BRYANT (NCC CCMHC CHT LPCC-S), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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