Provider Demographics
NPI:1760552293
Name:LUNGU, ANN MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:
Last Name:LUNGU
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22741 GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-2929
Mailing Address - Country:US
Mailing Address - Phone:248-520-6710
Mailing Address - Fax:
Practice Address - Street 1:11111 HALL RD STE 422
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5716
Practice Address - Country:US
Practice Address - Phone:586-307-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801074061104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801074061OtherMASTER'S SOCIAL WORKER