Individual
ANDRAE TERELL AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548
(616) 455-5270
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801100197
MI
1041C0700X
Clinical Social Worker
Primary
6801116516
MI
Other
Enumeration date
11/18/2019
Last updated
03/26/2025
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