Provider Demographics
NPI:1760091953
Name:MILLS, TANGELA ROCHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:TANGELA
Middle Name:ROCHELLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TANGELA
Other - Middle Name:ROCHELLE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9155 SCHAEFER RD UNIT 1304
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1278
Mailing Address - Country:US
Mailing Address - Phone:210-372-8272
Mailing Address - Fax:
Practice Address - Street 1:BROOKE ARMY MEDICAL CENTER
Practice Address - Street 2:3551 ROGER BROOKE DRIVE
Practice Address - City:FT. SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234
Practice Address - Country:US
Practice Address - Phone:726-228-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
TX579741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical