Provider Demographics
NPI:1245923408
Name:ANDERSON, GAIL (LLMSW)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43067 HIDDENCOVE CT APT 1401
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-3285
Mailing Address - Country:US
Mailing Address - Phone:248-826-7727
Mailing Address - Fax:
Practice Address - Street 1:27780 NOVI RD STE 244
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3427
Practice Address - Country:US
Practice Address - Phone:248-826-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511168661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical