Provider Demographics
NPI:1285921981
Name:THIEL, ANGELA LYNN (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LYNN
Last Name:THIEL
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:LYNN
Other - Last Name:LONSWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4224
Mailing Address - Country:US
Mailing Address - Phone:989-797-3400
Mailing Address - Fax:989-797-3477
Practice Address - Street 1:500 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4224
Practice Address - Country:US
Practice Address - Phone:989-797-3400
Practice Address - Fax:989-797-0206
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MI68511073451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker