MEDICARE: MS. MARY MAYE MILLS LMHCA, SUDP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CO60198504	WA
2	101YM0800X	Mental Health Counselor	LH1119165	WA

General Provider Information

NPI Number	:	1558636910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY MAYE MILLS LMHCA, SUDP

Provider Business Mailing Address
First Line	:	600 N 36TH ST STE 315
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8698
Country	:	US
Telephone Number	:	206-607-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N 36TH ST STE 315
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8698
Country	:	US
Telephone Number	:	206-607-8866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	04/10/2021

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