Provider Demographics
NPI:1467603704
Name:MILLS, VIRGINIA H (MAED, LPCS, LCAS)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:H
Last Name:MILLS
Suffix:
Gender:F
Credentials:MAED, LPCS, LCAS
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:H
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2084 HEIDELBURG DR.
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106
Mailing Address - Country:US
Mailing Address - Phone:336-923-7426
Mailing Address - Fax:704-625-3617
Practice Address - Street 1:1066 W. 4TH ST.
Practice Address - Street 2:SUITES 101, 201 & 202
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101
Practice Address - Country:US
Practice Address - Phone:336-923-7426
Practice Address - Fax:704-625-3617
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2943101YA0400X, 101YM0800X
NC2943LPC101YP2500X
NC1426LCAS101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health