Provider Demographics
NPI:1427664937
Name:THREATT, ARMONIQUE (LLMSW)
Entity type:Individual
Prefix:MS
First Name:ARMONIQUE
Middle Name:
Last Name:THREATT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:ARMONIQUE
Other - Middle Name:
Other - Last Name:THREATT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLMSW
Mailing Address - Street 1:6549 TOWN CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:248-620-6400
Mailing Address - Fax:313-865-1582
Practice Address - Street 1:32961 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1729
Practice Address - Country:US
Practice Address - Phone:248-855-1540
Practice Address - Fax:313-865-1582
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801107586101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1912062068Medicaid