Provider Demographics
NPI:1528621430
Name:MILLS, E'SHERECA (MED, LPC)
Entity type:Individual
Prefix:
First Name:E'SHERECA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1974
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77592-1974
Mailing Address - Country:US
Mailing Address - Phone:409-919-3489
Mailing Address - Fax:
Practice Address - Street 1:2000 25TH AVE N STE 116
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-5280
Practice Address - Country:US
Practice Address - Phone:409-919-3489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77505101YM0800X, 101YP2500X
LA10148101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional