Healthcare Provider Details

I. General information

NPI: 1295322253
Provider Name (Legal Business Name): JULIE E MILLS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2020
Last Update Date: 12/24/2020
Certification Date: 12/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 S MAIN ST
NEWMARKET NH
03857-1835
US

IV. Provider business mailing address

207 S MAIN ST
NEWMARKET NH
03857-1843
US

V. Phone/Fax

Practice location:
  • Phone: 603-659-3106
  • Fax:
Mailing address:
  • Phone: 603-292-7292
  • Fax: 603-659-5892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2199
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: