Provider Demographics
NPI:1942007190
Name:BURNS, ANGEL MICHELLE (LLCSW)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MICHELLE
Last Name:BURNS
Suffix:
Gender:F
Credentials:LLCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3856 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MI
Mailing Address - Zip Code:49419-9748
Mailing Address - Country:US
Mailing Address - Phone:616-610-1589
Mailing Address - Fax:
Practice Address - Street 1:3856 144TH AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MI
Practice Address - Zip Code:49419-9748
Practice Address - Country:US
Practice Address - Phone:616-610-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851119184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health