Provider Demographics
NPI:1639670144
Name:DANGC, BRIANNE (LMSW)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:DANGC
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 1:1774 E ROUND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-8403
Mailing Address - Country:US
Mailing Address - Phone:517-449-4162
Mailing Address - Fax:888-524-3718
Practice Address - Street 1:126 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8839
Practice Address - Country:US
Practice Address - Phone:517-449-4162
Practice Address - Fax:888-524-3718
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010984291041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical