Provider Demographics
NPI:1386088235
Name:QUARTON, MICHELLE ANGELILLO (LMSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANGELILLO
Last Name:QUARTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ANGEILLLO
Other - Last Name:QUARTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:3781 IRIS DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-1114
Mailing Address - Country:US
Mailing Address - Phone:248-342-8001
Mailing Address - Fax:
Practice Address - Street 1:3781 IRIS DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-1114
Practice Address - Country:US
Practice Address - Phone:248-342-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010801691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical