Healthcare Provider Details

I. General information

NPI: 1750891347
Provider Name (Legal Business Name): KRISTINE MILLS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 N TELSHOR BLVD STE C
LAS CRUCES NM
88011-8201
US

IV. Provider business mailing address

4720 ZENO PL
LAS CRUCES NM
88012-8010
US

V. Phone/Fax

Practice location:
  • Phone: 575-650-5946
  • Fax:
Mailing address:
  • Phone: 575-386-0408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number98083
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCCMH0212651
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: