Provider Demographics
NPI:1558636910
Name:MILLS, MARY MAYE (LMHCA, SUDP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:MAYE
Last Name:MILLS
Suffix:
Gender:F
Credentials:LMHCA, SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N 36TH ST STE 315
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8698
Mailing Address - Country:US
Mailing Address - Phone:206-607-8866
Mailing Address - Fax:
Practice Address - Street 1:600 N 36TH ST STE 315
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8698
Practice Address - Country:US
Practice Address - Phone:206-607-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60198504101YA0400X
WALH1119165101YM0800X
WAMC60978543101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)