Provider Demographics
NPI:1467214288
Name:MCMILLAN, ANNIE ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:ELIZABETH
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 S ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4341
Mailing Address - Country:US
Mailing Address - Phone:605-351-1483
Mailing Address - Fax:
Practice Address - Street 1:5021 S BUR OAK PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2228
Practice Address - Country:US
Practice Address - Phone:605-351-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6487104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker