Healthcare Provider Details

I. General information

NPI: 1427976570
Provider Name (Legal Business Name): MATTHEW DONOVAN MILLS LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 PACKARD ST
ANN ARBOR MI
48108-1521
US

IV. Provider business mailing address

29693 ENGLISH WAY
NOVI MI
48377-2031
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-0155
  • Fax: 734-971-2730
Mailing address:
  • Phone: 248-410-1992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6851121353
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: