Provider Demographics
NPI:1760662308
Name:LOUISE MILLS-DUMONCEAUX
Entity Type:Organization
Organization Name:LOUISE MILLS-DUMONCEAUX
Other - Org Name:CHILD & FAMILY COUNSELING SERVICES, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLS-DUMONCEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-585-4589
Mailing Address - Street 1:61 SHELTON CT
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-4233
Mailing Address - Country:US
Mailing Address - Phone:919-585-4589
Mailing Address - Fax:919-585-4589
Practice Address - Street 1:105 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2486
Practice Address - Country:US
Practice Address - Phone:919-585-4589
Practice Address - Fax:919-585-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005754251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106801Medicaid
NC2860068Medicare PIN