MEDICARE: MS. CAROL P. MILLS LCSW

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	1041C0700X	Clinical Social Worker	LCS13712	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	490226	OTHER	CA	MHN PIN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851462568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL P. MILLS LCSW

Provider Business Mailing Address
First Line	:	47 MILTON ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-1427
Country	:	US
Telephone Number	:	415-584-1708
Fax Number	:

Provider Business Practice Location Address
First Line	:	3890 24TH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-3839
Country	:	US
Telephone Number	:	415-584-1708
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	12/09/2011

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