Provider Demographics
NPI:1144791526
Name:MILLS MAI, ALICE (MA, LPCC-S)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:MILLS MAI
Suffix:
Gender:F
Credentials:MA, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 RIVERSIDE DR STE 352
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4012
Mailing Address - Country:US
Mailing Address - Phone:740-803-3821
Mailing Address - Fax:
Practice Address - Street 1:450 ALKYRE RUN STE 250
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6076
Practice Address - Country:US
Practice Address - Phone:614-705-2585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009097101YM0800X
OHE.2001927-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health