Provider Demographics
NPI:1992852651
Name:MILLS, MARJORIE S (LPC)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:S
Last Name:MILLS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 ROCKLEDGE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-3159
Mailing Address - Country:US
Mailing Address - Phone:412-266-8210
Mailing Address - Fax:724-934-3906
Practice Address - Street 1:117 VIP DR STE 310
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6936
Practice Address - Country:US
Practice Address - Phone:724-934-3905
Practice Address - Fax:724-934-3906
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004320101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC004320OtherPROFESSIONAL COUNSELOR LICENSE