Provider Demographics
NPI:1891945309
Name:MILLS SPRING COUNSELING PLLC
Entity Type:Organization
Organization Name:MILLS SPRING COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-297-7900
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:FORTINE
Mailing Address - State:MT
Mailing Address - Zip Code:59918-0217
Mailing Address - Country:US
Mailing Address - Phone:406-297-7900
Mailing Address - Fax:406-297-7900
Practice Address - Street 1:99 MILLS SPRING RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9153
Practice Address - Country:US
Practice Address - Phone:406-297-7900
Practice Address - Fax:406-297-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1891945309Medicaid
MT1891945309Medicaid