Provider Demographics
NPI:1619385861
Name:MILLS COUNSELING, INC IN CARE OF ASHLEY C MILLS
Entity Type:Organization
Organization Name:MILLS COUNSELING, INC IN CARE OF ASHLEY C MILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:CAROLINE
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:704-964-8170
Mailing Address - Street 1:4425 RANDOLPH RD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2351
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007561Medicaid
NC6007561Medicaid