Provider Demographics
NPI:1528942364
Name:GARDNER, ANGELA MCQUIVEY (LMSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MCQUIVEY
Last Name:GARDNER
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 1:18554 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3360
Mailing Address - Country:US
Mailing Address - Phone:734-386-6287
Mailing Address - Fax:
Practice Address - Street 1:18554 SUNSET ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3360
Practice Address - Country:US
Practice Address - Phone:248-465-5482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011078091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty