Provider Demographics
NPI:1588948236
Name:MILLS, LAURA L (LCPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MILLS
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31526 S WILL CENTER RD
Mailing Address - Street 2:
Mailing Address - City:PEOTONE
Mailing Address - State:IL
Mailing Address - Zip Code:60468-9142
Mailing Address - Country:US
Mailing Address - Phone:779-529-0825
Mailing Address - Fax:
Practice Address - Street 1:110 MOONEY DR STE 1
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2172
Practice Address - Country:US
Practice Address - Phone:779-529-0825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.013702101YM0800X
IL178.005956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health