Provider Demographics
NPI:1760091953
Name:MILLS, TANGELA ROCHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:TANGELA
Middle Name:ROCHELLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TANGELA
Other - Middle Name:ROCHELLE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9155 SCHAEFER RD UNIT 1304
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1278
Mailing Address - Country:US
Mailing Address - Phone:210-372-8272
Mailing Address - Fax:
Practice Address - Street 1:9155 SCHAEFER RD UNIT 1304
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1278
Practice Address - Country:US
Practice Address - Phone:210-383-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX579741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical