Provider Demographics
NPI:1881821650
Name:MILLS, MELANIE L (LPC, CAC II, ATR-BC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:MILLS
Suffix:
Gender:F
Credentials:LPC, CAC II, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6142
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6142
Mailing Address - Country:US
Mailing Address - Phone:912-436-6481
Mailing Address - Fax:866-713-3003
Practice Address - Street 1:24 COMMERCE PL # D
Practice Address - Street 2:# D
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-436-6481
Practice Address - Fax:866-713-3003
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004818101YP2500X
GALPC004818101YP2500X
COACB0005000101YA0400X
96-011221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist