Provider Demographics
NPI:1184089708
Name:PINEDA, ANGELICA GEORGINA (LMSW)
Entity type:Individual
Prefix:MISS
First Name:ANGELICA
Middle Name:GEORGINA
Last Name:PINEDA
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 1:4255 CAYUGA TRL
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3581
Mailing Address - Country:US
Mailing Address - Phone:810-515-9839
Mailing Address - Fax:
Practice Address - Street 1:4255 CAYUGA TRL
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3581
Practice Address - Country:US
Practice Address - Phone:810-515-9839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-26
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MI68011138011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator