Provider Demographics
NPI:1104514793
Name:CASE, ANGELA R (LMSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:CASE
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 1:216 E CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49348-1104
Mailing Address - Country:US
Mailing Address - Phone:616-617-9926
Mailing Address - Fax:
Practice Address - Street 1:216 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1104
Practice Address - Country:US
Practice Address - Phone:616-617-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851096902104100000X
MI68011203191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker