Provider Demographics
NPI:1396390456
Name:MILLS, CHRISTINE ANNE (MSW; LCSWA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANNE
Last Name:MILLS
Suffix:
Gender:F
Credentials:MSW; LCSWA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANNE
Other - Last Name:FERRARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5130 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-8371
Mailing Address - Country:US
Mailing Address - Phone:336-790-9787
Mailing Address - Fax:336-790-9786
Practice Address - Street 1:2031 MARTIN LUTHER KING JR DR STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3300
Practice Address - Country:US
Practice Address - Phone:336-790-9787
Practice Address - Fax:336-790-9786
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0139181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical