Provider Demographics
NPI:1356564983
Name:MILLS PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:MILLS PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:CHAMBERS
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:717-303-0444
Mailing Address - Street 1:355 N 21ST ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-3707
Mailing Address - Country:US
Mailing Address - Phone:717-303-0444
Mailing Address - Fax:717-303-0108
Practice Address - Street 1:355 N 21ST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-3707
Practice Address - Country:US
Practice Address - Phone:717-303-0444
Practice Address - Fax:717-303-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008182L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA467319OtherCBC
PA61-23547OtherUBH
PA1175528OtherCIGNA
PA50026450OtherHBS
PA61-23547OtherUBH
PAMI809210Medicare ID - Type UnspecifiedMEDICARE