MEDICARE: ARLENE MILLS CASAC T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1073322855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLENE MILLS CASAC T

Provider Business Mailing Address
First Line	:	1150 SOUTH AVE STE 2ND
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3404
Country	:	US
Telephone Number	:	917-544-8901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 SOUTH AVE STE 2ND
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3404
Country	:	US
Telephone Number	:	917-544-8901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	01/06/2025

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