Provider Demographics
NPI:1740998103
Name:MILLS, WILLIAM III (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:MILLS
Suffix:III
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 REDBUD RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5926
Mailing Address - Country:US
Mailing Address - Phone:732-882-8360
Mailing Address - Fax:
Practice Address - Street 1:55 REDBUD RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-5926
Practice Address - Country:US
Practice Address - Phone:732-882-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00660200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional