Provider Demographics
NPI:1952874489
Name:MILLS, JEAN CATHERINE (LICSW, MED, CAGS)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:CATHERINE
Last Name:MILLS
Suffix:
Gender:F
Credentials:LICSW, MED, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3568
Mailing Address - Country:US
Mailing Address - Phone:781-246-0810
Mailing Address - Fax:
Practice Address - Street 1:100 HEMLOCK RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3568
Practice Address - Country:US
Practice Address - Phone:781-246-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool