Provider Demographics
NPI:1316418106
Name:BOIKE, KRISTEN LEE (MS, LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEE
Last Name:BOIKE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36400 WOODWARD AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-0913
Mailing Address - Country:US
Mailing Address - Phone:248-629-2799
Mailing Address - Fax:
Practice Address - Street 1:36400 WOODWARD AVE STE 222
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0913
Practice Address - Country:US
Practice Address - Phone:248-629-2799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019308101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional