MEDICARE: ANGELA HUNTER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		MI
2	101YP2500X	Professional Counselor	6401222865	MI

General Provider Information

NPI Number	:	1972898195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA HUNTER LPC

Provider Business Mailing Address
First Line	:	14799 DIX TOLEDO RD
Second Line	:
City	:	SOUTHGATE
State	:	MI
Zip	:	48195-2507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26711 WOODWARD AVE STE 306
Second Line	:
City	:	HUNTINGTON WOODS
State	:	MI
Zip	:	48070-1369
Country	:	US
Telephone Number	:	248-860-2024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	08/29/2022

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