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General NPI Number Information
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NPI Number | 1629590658
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Entity Type | Individual
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Provider Name | RACHEL SHANGO
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Gender | Female
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1700 W BIG BEAVER RD STE 200
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City | TROY
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State | MI
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Zip | 48084-3524
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Country | US
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Telephone | 248-608-4514
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Fax |
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Provider Business Mailing Address
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Address Line | 7897 ACADEMY CT E
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City | WATERFORD TWP
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State | MI
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Zip | 48329-4631
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Country | US
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Telephone |
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 685117991
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License Number State | MI
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