Provider Demographics
NPI:1922605849
Name:MILLS, MARIE HOLLAND (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:HOLLAND
Last Name:MILLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:HOLLAND
Other - Last Name:MINNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:452 GLENKIRK PL
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-9282
Mailing Address - Country:US
Mailing Address - Phone:804-381-1036
Mailing Address - Fax:
Practice Address - Street 1:3000 HIGHWOODS BLVD STE 310
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1029
Practice Address - Country:US
Practice Address - Phone:919-714-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-04
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0123041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical