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NPI 1427664937

NPI 1427664937 : ARMONIQUE THREATT LLMSW : FARMINGTON HILLS, MI

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General NPI Number Information
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    NPI Number           |    1427664937
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    Entity Type          |    Individual 
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    Provider Name        |    ARMONIQUE THREATT LLMSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/21/2020
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    Last Update Date     |    05/11/2021
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Provider Practice Location Address
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    Address Line         |    32961 MIDDLEBELT RD 
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    City                 |    FARMINGTON HILLS
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    State                |    MI
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    Zip                  |    48334-1729
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    Country              |    US
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    Telephone            |    248-855-1540
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    Fax                  |    313-865-1582
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Provider Business Mailing Address
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    Address Line         |    6549 TOWN CENTER DR STE A 
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    City                 |    CLARKSTON
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    State                |    MI
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    Zip                  |    48346-4824
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    Country              |    US
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    Telephone            |    248-620-6400
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    Fax                  |    313-865-1582
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    6801107586
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    6801107586
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    License Number State |    MI
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