Provider Demographics
NPI:1881469575
Name:MCMILLAN, CHRISTY L (LMSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24613 STONEY RUN RD SW
Mailing Address - Street 2:
Mailing Address - City:WESTERNPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21562-2126
Mailing Address - Country:US
Mailing Address - Phone:301-876-0892
Mailing Address - Fax:
Practice Address - Street 1:323 PACA ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2816
Practice Address - Country:US
Practice Address - Phone:301-268-6536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29798104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker