Provider Demographics
NPI:1235587270
Name:RINEARSON, ANGELIQUE (LMSW)
Entity Type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:
Last Name:RINEARSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 EASTMAN AVE STE 173
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6795
Mailing Address - Country:US
Mailing Address - Phone:989-289-1497
Mailing Address - Fax:
Practice Address - Street 1:5103 EASTMAN AVE STE 173
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6795
Practice Address - Country:US
Practice Address - Phone:989-289-1497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010941391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical