Provider Demographics
NPI:1033496583
Name:MILLS, NATALIE ROSALYN (LPC, MFT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSALYN
Last Name:MILLS
Suffix:
Gender:F
Credentials:LPC, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 DORAL CT
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4324
Mailing Address - Country:US
Mailing Address - Phone:503-882-6237
Mailing Address - Fax:
Practice Address - Street 1:2066 DORAL CT
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4324
Practice Address - Country:US
Practice Address - Phone:503-882-6237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional