Provider Demographics
NPI:1306401484
Name:KATRINA M MILLIKEN PLLC
Entity Type:Organization
Organization Name:KATRINA M MILLIKEN PLLC
Other - Org Name:GRACE BEHAVIORAL HEALTH OF MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-978-3584
Mailing Address - Street 1:572 PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:GREGORY
Mailing Address - State:MI
Mailing Address - Zip Code:48137-9580
Mailing Address - Country:US
Mailing Address - Phone:248-978-3584
Mailing Address - Fax:248-592-7240
Practice Address - Street 1:134 W MIDDLE ST STE I
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1515
Practice Address - Country:US
Practice Address - Phone:248-491-8840
Practice Address - Fax:248-592-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-05
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty