Provider Demographics
NPI:1356305007
Name:MILLS, CASEY (LPC NCC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2383 LULU LN S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2989
Mailing Address - Country:US
Mailing Address - Phone:503-508-5700
Mailing Address - Fax:
Practice Address - Street 1:3295 TRIANGLE DR SE STE 105
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4566
Practice Address - Country:US
Practice Address - Phone:503-930-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1284101YP2500X
ORC1284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional