Healthcare Provider Details

I. General information

NPI: 1427177021
Provider Name (Legal Business Name): HAROLD D MCMILLION PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 COMMERCE ST D
GREENVILLE NC
27858-5027
US

IV. Provider business mailing address

PO BOX 30696
GREENVILLE NC
27833-0696
US

V. Phone/Fax

Practice location:
  • Phone: 252-355-2768
  • Fax: 252-355-0403
Mailing address:
  • Phone: 252-353-7162
  • Fax: 252-353-1760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number753
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: