Provider Demographics
NPI:1497869432
Name:MILLS, ELIZABETH ANNE (MA, ATR-BC, LPC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:MILLS
Suffix:
Gender:F
Credentials:MA, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9853
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-0475
Mailing Address - Country:US
Mailing Address - Phone:703-914-1078
Mailing Address - Fax:703-663-8817
Practice Address - Street 1:3811 PORTER ST NW
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2955
Practice Address - Country:US
Practice Address - Phone:703-914-1078
Practice Address - Fax:703-663-8817
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC1127101YP2500X, 101Y00000X, 101YM0800X, 221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCU679-0001OtherCAREFIRST BLUECROSS BLUESHIELD
DC600240585OtherMAGELLAN BEHAVIORAL HEALTH