Provider Demographics
NPI:1558556134
Name:MILLS, DAWN M (CADC,LSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:MILLS
Suffix:
Gender:F
Credentials:CADC,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-5653
Mailing Address - Country:US
Mailing Address - Phone:207-743-1677
Mailing Address - Fax:207-743-1614
Practice Address - Street 1:28 WINTER ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5653
Practice Address - Country:US
Practice Address - Phone:207-743-1677
Practice Address - Fax:207-743-1614
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC4043101YA0400X
MELSX10118104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME031599OtherANTHEM BC BS
ME432056100Medicaid