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General NPI Number Information
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NPI Number | 1558636910
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Entity Type | Individual
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Provider Name | MARY MAYE MILLS LMHCA, SUDP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 04/10/2021
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Provider Practice Location Address
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Address Line | 600 N 36TH ST STE 315
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City | SEATTLE
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State | WA
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Zip | 98103-8698
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Country | US
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Telephone | 206-607-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N 36TH ST STE 315
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City | SEATTLE
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State | WA
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Zip | 98103-8698
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Country | US
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Telephone | 206-607-8866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CO60198504
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH1119165
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License Number State | WA
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