Provider Demographics
NPI:1619164571
Name:MILLS, CHRISTOPHER DOUGLAS (LIAC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DOUGLAS
Last Name:MILLS
Suffix:
Gender:M
Credentials:LIAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 S WILLARD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4126
Mailing Address - Country:US
Mailing Address - Phone:928-925-9087
Mailing Address - Fax:
Practice Address - Street 1:340 S WILLARD ST STE 201
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4126
Practice Address - Country:US
Practice Address - Phone:928-925-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
AZ155275101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)