Provider Demographics
NPI:1134004054
Name:MILLER MENTAL HEALTH STAFFING
Entity type:Organization
Organization Name:MILLER MENTAL HEALTH STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:517-575-7903
Mailing Address - Street 1:5190 TWINGING DR
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-2976
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:517-201-0607
Practice Address - Street 1:5190 TWINGING DR
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2976
Practice Address - Country:US
Practice Address - Phone:919-964-5537
Practice Address - Fax:517-201-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health