Provider Demographics
NPI:1881302578
Name:HUNTINGTON-MILLER, KRISTINA (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:HUNTINGTON-MILLER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16291 BAYHAM CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1922
Mailing Address - Country:US
Mailing Address - Phone:586-872-3165
Mailing Address - Fax:
Practice Address - Street 1:30472 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-1844
Practice Address - Country:US
Practice Address - Phone:586-863-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511156891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical