Provider Demographics
NPI:1629025945
Name:HARRELL, ANN MILLNER (MED,LPC, NCC, ADTR)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MILLNER
Last Name:HARRELL
Suffix:
Gender:F
Credentials:MED,LPC, NCC, ADTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 TENNYSON CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2440
Mailing Address - Country:US
Mailing Address - Phone:336-282-5972
Mailing Address - Fax:336-854-0099
Practice Address - Street 1:612 PASTEUR DR
Practice Address - Street 2:STE. 104
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1149
Practice Address - Country:US
Practice Address - Phone:336-707-6933
Practice Address - Fax:336-854-0099
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1321UOtherBCBS OF NC PROVIDER ID #
NC6102081Medicaid