Healthcare Provider Details

I. General information

NPI: 1063235737
Provider Name (Legal Business Name): CHRISTINE ANN RILEY LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE ANN DUNAJ

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MIDMICHIGAN HEALTH SERVICES-HOUGHTON LAKE SCHOOL BASED 4433 W LAKE CITY RD
HOUGHTON LAKE MI
48629-9602
US

IV. Provider business mailing address

1105 SIXTH ST
TRAVERSE CITY MI
49684-2345
US

V. Phone/Fax

Practice location:
  • Phone: 989-422-5122
  • Fax: 989-422-4378
Mailing address:
  • Phone: 231-935-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851119106
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: