Provider Demographics
NPI:1023023843
Name:PERSENAIRE, ADRIANA (LMSW, DCSW)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:
Last Name:PERSENAIRE
Suffix:
Gender:F
Credentials:LMSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 HOLIDAY TER
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2161
Mailing Address - Country:US
Mailing Address - Phone:269-372-4500
Mailing Address - Fax:269-372-7230
Practice Address - Street 1:5400 HOLIDAY TER
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2161
Practice Address - Country:US
Practice Address - Phone:269-372-4500
Practice Address - Fax:269-372-7230
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010601351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical