Provider Demographics
NPI:1265844252
Name:DEANNA L. MILLS
Entity Type:Organization
Organization Name:DEANNA L. MILLS
Other - Org Name:DEANNA L. MILLS NYC
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:LIZZETT
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:347-204-5865
Mailing Address - Street 1:655 W 190TH ST
Mailing Address - Street 2:#23
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4153
Mailing Address - Country:US
Mailing Address - Phone:347-204-5864
Mailing Address - Fax:
Practice Address - Street 1:655 W 190TH ST
Practice Address - Street 2:#23
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-4153
Practice Address - Country:US
Practice Address - Phone:347-204-5864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006107101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty