MILYAN MCKISSACK
NPI 1114572088
Case Manager/Care Coordinator in Grand Rapids, MI

Q: What is Milyan Mckissack's NPI number?

The NPI number for Milyan Mckissack is 1114572088. It was assigned to this individual provider in the NPPES registry on August 7, 2019.

Q: What is Milyan Mckissack's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Q: When was this NPI record last updated?

The NPPES record for Milyan Mckissack was last updated on March 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 07, 2019

790 FULLER AVE NE, GRAND RAPIDS, MI 49503(616) 336-3909(616) 336-8830 Get Directions Write a Review

NPPES record last updated: March 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 3, 2022, Aug 7, 2019 (2 updates tracked since 2019).

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About Milyan Mckissack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MILYAN MCKISSACK (NPI 1114572088) is an individual case manager/care coordinator provider in Grand Rapids, Michigan and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1114572088

Entity TypeIndividualFemale

Primary Taxonomy171M00000X

Provider Legal NameMILYAN MCKISSACK

Location Address790 FULLER AVE NEGrand Rapids, MI 49503-1918

Mailing Address790 Fuller Ave NeGrand Rapids, MI 49503-1918 · (616) 336-3909 · Fax (616) 336-8830

Phone(616) 336-3909

Fax(616) 336-8830

Sole ProprietorNo

Enumeration DateAugust 7, 2019

Last NPPES UpdateMarch 3, 20222 updates tracked since enumeration

NPPES CertifiedMarch 3, 2022

✔ NPI 1114572088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Also ListedBehavior TechnicianTaxonomy 106S00000X

790 FULLER AVE NE, Grand Rapids, MI 49503

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANA DUARTE-MENENDEZ LMSW

Social Worker (Clinical)