Provider Demographics
NPI:1043191901
Name:ARMITAGE-GAEGAUF, AUDREY KAY (LMSW)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:KAY
Last Name:ARMITAGE-GAEGAUF
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 E LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-3450
Mailing Address - Country:US
Mailing Address - Phone:248-807-4095
Mailing Address - Fax:
Practice Address - Street 1:627 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1961
Practice Address - Country:US
Practice Address - Phone:248-329-3879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011067471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical