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General NPI Number Information
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NPI Number | 1134004054
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Entity Type | Organization
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Legal Business Name | MILLER MENTAL HEALTH STAFFING
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 11/22/2025
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Provider Practice Location Address
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Address Line | 5190 TWINGING DR
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City | OKEMOS
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State | MI
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Zip | 48864-2976
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Country | US
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Telephone | 919-964-5537
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Fax | 517-201-0607
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Provider Business Mailing Address
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Address Line | 4211 OKEMOS RD STE 12
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City | OKEMOS
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State | MI
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Zip | 48864-3287
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Country | US
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Telephone | 517-214-9779
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Fax | 517-201-0607
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANDREA MILLER
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Credential | PMHNP
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Telephone | 517-575-7903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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