Provider Demographics
NPI:1710206982
Name:MILLS, PAMELA KAY (CHT, CAC III)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:KAY
Last Name:MILLS
Suffix:
Gender:F
Credentials:CHT, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 S HAVANA ST
Mailing Address - Street 2:#308
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4018
Mailing Address - Country:US
Mailing Address - Phone:303-343-0361
Mailing Address - Fax:888-851-0375
Practice Address - Street 1:1450 S HAVANA ST
Practice Address - Street 2:#308
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4018
Practice Address - Country:US
Practice Address - Phone:303-343-0361
Practice Address - Fax:888-851-0375
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
COCLINICAL HYPNOTHERAP101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)