Basic Information
| Provider Information | |||||||||
| NPI: | 1700815388 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARSIGLIO | ||||||||
| FirstName: | ANGEL | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24715 LITTLE MACK, ADVANCED COUNSELING SERVICES, P.C. | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ST. CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480803207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867779000 | ||||||||
| FaxNumber: | 5867770823 | ||||||||
| Practice Location | |||||||||
| Address1: | 24715 LITTLE MACK, DOWNRIVER MENTAL HEALTH | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ST. CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480803207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867779000 | ||||||||
| FaxNumber: | 5867770823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 68010034055 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.