Provider Demographics
NPI:1568782654
Name:MILLS, ASHLEY CAROLINE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:CAROLINE
Last Name:MILLS
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 1:9233 ROTHERHAM LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-1774
Mailing Address - Country:US
Mailing Address - Phone:704-964-8170
Mailing Address - Fax:704-910-2720
Practice Address - Street 1:4425 RANDOLPH RD
Practice Address - Street 2:SUITE 217
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2351
Practice Address - Country:US
Practice Address - Phone:704-964-8170
Practice Address - Fax:704-910-2720
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007561Medicaid
NCMILAM01OtherBLUE CROSS BLUE SHIELD NC
NCMILAM01OtherBLUE CROSS BLUE SHIELD NC