Provider Demographics
NPI:1841460078
Name:GRIFFIN, ANGELA TERRI (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:TERRI
Last Name:GRIFFIN
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 1:42125 FREEPORT CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-2348
Mailing Address - Country:US
Mailing Address - Phone:313-576-3345
Mailing Address - Fax:313-576-1091
Practice Address - Street 1:4646 JOHN R ST
Practice Address - Street 2:JOHN D. DINGELL VA
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-576-3345
Practice Address - Fax:313-576-1091
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010864931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical