Provider Demographics
NPI:1932340718
Name:MILLS, ANGELA B (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:MILLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:J
Other - Last Name:BARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:557 HILDEBRAND
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614
Mailing Address - Country:US
Mailing Address - Phone:574-261-2416
Mailing Address - Fax:574-222-2468
Practice Address - Street 1:53846 GENERATIONS DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1543
Practice Address - Country:US
Practice Address - Phone:574-261-2416
Practice Address - Fax:574-807-9616
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005810A101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health