Provider Demographics
NPI:1154378172
Name:PIETRANGELO, HALA S (LMSW)
Entity type:Individual
Prefix:
First Name:HALA
Middle Name:S
Last Name:PIETRANGELO
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 1:42500 HAYES RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6768
Mailing Address - Country:US
Mailing Address - Phone:586-828-1221
Mailing Address - Fax:586-421-4705
Practice Address - Street 1:42500 HAYES RD STE 500
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6768
Practice Address - Country:US
Practice Address - Phone:586-828-1221
Practice Address - Fax:586-421-4705
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801078182101YM0800X
1041C0700X
68010781821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3434247Medicaid
MI3434247Medicaid