Provider Demographics
NPI:1528837960
Name:MILLS PRO COUNSELING LLC
Entity type:Organization
Organization Name:MILLS PRO COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CCMHC
Authorized Official - Phone:580-373-2820
Mailing Address - Street 1:1205 PEBBLE TRL
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-3808
Mailing Address - Country:US
Mailing Address - Phone:580-373-2820
Mailing Address - Fax:580-547-5242
Practice Address - Street 1:1205 PEBBLE TRL
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:OK
Practice Address - Zip Code:73538-3808
Practice Address - Country:US
Practice Address - Phone:580-373-2820
Practice Address - Fax:580-547-5242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health