Provider Demographics
NPI:1316108863
Name:MILLS, DEBRA (LMHC, LADC-I)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:LMHC, LADC-I
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4721
Mailing Address - Country:US
Mailing Address - Phone:603-531-3704
Mailing Address - Fax:978-564-7541
Practice Address - Street 1:204 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4721
Practice Address - Country:US
Practice Address - Phone:603-531-3704
Practice Address - Fax:978-564-7541
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11340101YA0400X
NHLADC: 649101YA0400X
NHLCMHC: 729101YM0800X
MA8649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99003227Medicaid
7706655Y0NH01OtherBHN
NH7706655Y0NH01OtherBHN