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General NPI Number Information
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NPI Number | 1154960458
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Entity Type | Organization
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Legal Business Name | MILLS SUPPORTIVE COUNSELING LLC
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 55 E 100 N
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City | SPANISH FORK
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State | UT
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Zip | 84660-1805
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Country | US
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Telephone | 385-448-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 1197 E 540 N
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City | SPANISH FORK
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State | UT
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Zip | 84660-8002
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Country | US
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Telephone | 801-921-2049
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | CHERI MILLS
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Credential | LCSW
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Telephone | 801-921-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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