Provider Demographics
NPI:1194316273
Name:MULLER, HENRY ANDREW (MA LLPC)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:ANDREW
Last Name:MULLER
Suffix:
Gender:M
Credentials:MA LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 COVINGTON DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-4937
Mailing Address - Country:US
Mailing Address - Phone:161-656-0948
Mailing Address - Fax:
Practice Address - Street 1:2566 WOODMEADOW DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8031
Practice Address - Country:US
Practice Address - Phone:616-719-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019044101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional