Healthcare Provider Details

I. General information

NPI: 1912336819
Provider Name (Legal Business Name): ANGELA SNIECINSKI LMSW, CADC, QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA ZANDER LLMSW, LMSW, CADC

II. Dates (important events)

Enumeration Date: 11/01/2013
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 SUMMIT DR
WATERFORD MI
48328-3364
US

IV. Provider business mailing address

279 SUMMIT DR
WATERFORD MI
48328-3364
US

V. Phone/Fax

Practice location:
  • Phone: 248-745-4900
  • Fax:
Mailing address:
  • Phone: 248-745-4900
  • Fax: 248-994-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2-01355
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801104630
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801104630
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateMI
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801110666
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: