Provider Demographics
NPI:1437223716
Name:MILLS, JOSEPH E III (MDIV,MA,CADCII, MAC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:MILLS
Suffix:III
Gender:M
Credentials:MDIV,MA,CADCII, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11388 W OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1605
Mailing Address - Country:US
Mailing Address - Phone:310-268-2516
Mailing Address - Fax:
Practice Address - Street 1:11388 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1605
Practice Address - Country:US
Practice Address - Phone:310-268-2516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA3614393101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health