Provider Demographics
NPI:1619288636
Name:MILLIKEN, KATRINA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:MILLIKEN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:MARIE
Other - Last Name:LORENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1307 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1479
Mailing Address - Country:US
Mailing Address - Phone:248-491-8840
Mailing Address - Fax:248-592-7240
Practice Address - Street 1:1307 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1479
Practice Address - Country:US
Practice Address - Phone:248-491-8840
Practice Address - Fax:248-592-7240
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010913581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical