Provider Demographics
NPI:1043590029
Name:MILLS, LAEL REBECCA (LPCA)
Entity Type:Individual
Prefix:MRS
First Name:LAEL
Middle Name:REBECCA
Last Name:MILLS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 HIGHGATE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6623
Mailing Address - Country:US
Mailing Address - Phone:919-418-1718
Mailing Address - Fax:919-794-5715
Practice Address - Street 1:5315 HIGHGATE DR STE 102
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6623
Practice Address - Country:US
Practice Address - Phone:919-418-1718
Practice Address - Fax:919-794-5715
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health