Provider Demographics
NPI:1346736691
Name:DONNELL, DENISE MILLS (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MILLS
Last Name:DONNELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 AMARILLO BOULDEVARD WEST CLC-B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106
Mailing Address - Country:US
Mailing Address - Phone:806-355-9703
Mailing Address - Fax:806-468-1500
Practice Address - Street 1:6010 AMARILLO BOULDEVARD WEST CLC-B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:806-355-9703
Practice Address - Fax:806-468-1500
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64226104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker