Provider Demographics
NPI:1972822997
Name:MILLS, GINA MICHELLE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MICHELLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:MSW, LCSW
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 80
Mailing Address - Street 2:
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241-0080
Mailing Address - Country:US
Mailing Address - Phone:860-516-5672
Mailing Address - Fax:888-233-4694
Practice Address - Street 1:329 LEDGE RD
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-1923
Practice Address - Country:US
Practice Address - Phone:860-516-5672
Practice Address - Fax:888-233-4694
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0083871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical