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General NPI Number Information
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NPI Number | 1619399672
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Entity Type | Organization
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Legal Business Name | GINA M. MILLS, LCSW, LLC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 329 LEDGE RD
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City | DAYVILLE
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State | CT
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Zip | 06241-1923
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Country | US
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Telephone | 860-516-5672
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Fax | 888-233-4694
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Provider Business Mailing Address
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Address Line | PO BOX 80
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City | DAYVILLE
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State | CT
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Zip | 06241-0080
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Country | US
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Telephone | 860-516-5672
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Fax | 888-233-4694
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MRS. GINA MICHELLE MILLS
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Credential | LCSW
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Telephone | 860-516-5672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8387
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License Number State | CT
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