Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Angelique Gabrielle Prom, LMSW-CLINICAL

Individual provider Clinical Social Worker · NPI 1295460632

Mrs. Angelique Gabrielle Prom, LMSW-CLINICAL is a Clinical Social Worker in Ann Arbor, Michigan. Licensed in Michigan. Registered with an NPI since 2022.

Licensed in
MI
In the registry since
2022

Practice location Address checks out

2215 Fuller Rd
Ann Arbor, MI 48105-2303
Phone: (734) 769-7100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801110748 (MI)

Record details

NPI number1295460632
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW-CLINICAL
Sole proprietorNo
NPI enumeratedJuly 20, 2022
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022

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