Provider Demographics
NPI:1275711400
Name:MILLS, KIM DAWN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:DAWN
Last Name:MILLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SEVENOAKS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-8632
Mailing Address - Country:US
Mailing Address - Phone:214-876-7806
Mailing Address - Fax:817-431-6100
Practice Address - Street 1:3800 SEVENOAKS DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-8632
Practice Address - Country:US
Practice Address - Phone:214-876-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62112101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor