Provider Demographics
NPI:1518065127
Name:MILLEN, CORY LEIGH (LMSW)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:LEIGH
Last Name:MILLEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CORY
Other - Middle Name:LEIGH
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2280 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8503
Mailing Address - Country:US
Mailing Address - Phone:517-546-4126
Mailing Address - Fax:517-546-1300
Practice Address - Street 1:2280 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8503
Practice Address - Country:US
Practice Address - Phone:517-546-4126
Practice Address - Fax:517-546-1300
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical