Provider Demographics
NPI:1689827024
Name:WHITE-HALL, ANGELITA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELITA
Middle Name:
Last Name:WHITE-HALL
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 1:16400 N PARK DR
Mailing Address - Street 2:APT. 404
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4734
Mailing Address - Country:US
Mailing Address - Phone:248-395-3907
Mailing Address - Fax:248-355-3301
Practice Address - Street 1:29260 FRANKLIN RD
Practice Address - Street 2:SUITE 128
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1161
Practice Address - Country:US
Practice Address - Phone:248-355-3307
Practice Address - Fax:248-355-3392
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010875701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical