Provider Demographics
NPI:1124378997
Name:MILLS, LAMARR MICHAEL
Entity Type:Individual
Prefix:MR
First Name:LAMARR
Middle Name:MICHAEL
Last Name:MILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BENNETT AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2931
Mailing Address - Country:US
Mailing Address - Phone:626-354-2202
Mailing Address - Fax:
Practice Address - Street 1:3605 LONG BEACH BLVD #108
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:09807
Practice Address - Country:US
Practice Address - Phone:714-680-8201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker