Healthcare Provider Details

I. General information

NPI: 1033055041
Provider Name (Legal Business Name): CYNDI MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 TROWBRIDGE ST NE
GRAND RAPIDS MI
49503-1885
US

IV. Provider business mailing address

1899 ARBOR AVE
NORTON SHORES MI
49441-3701
US

V. Phone/Fax

Practice location:
  • Phone: 616-209-9295
  • Fax:
Mailing address:
  • Phone: 231-903-5699
  • Fax: 231-903-5699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: