Provider Demographics
NPI:1093606022
Name:DEPRIEST BEY, D'ANGELA
Entity type:Individual
Prefix:
First Name:D'ANGELA
Middle Name:
Last Name:DEPRIEST BEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 S EASTVIEW LN APT B2
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619-2626
Mailing Address - Country:US
Mailing Address - Phone:574-465-0274
Mailing Address - Fax:
Practice Address - Street 1:421 S EASTVIEW LN APT B2
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619-2626
Practice Address - Country:US
Practice Address - Phone:574-465-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator