Provider Demographics
NPI:1962643593
Name:POPOFF, ANGELA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:POPOFF
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 1:20300 CIVIC CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4105
Mailing Address - Country:US
Mailing Address - Phone:248-996-1035
Mailing Address - Fax:248-351-0417
Practice Address - Street 1:20300 CIVIC CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4105
Practice Address - Country:US
Practice Address - Phone:248-996-1035
Practice Address - Fax:248-351-0417
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010782631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical