Provider Demographics
NPI:1972263697
Name:VISARRAGA-MILLS, HELEN (LCSW)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:VISARRAGA-MILLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:VISARRAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:RANCHOS DE TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87557-0173
Mailing Address - Country:US
Mailing Address - Phone:971-222-4323
Mailing Address - Fax:
Practice Address - Street 1:108 SIERRA VISTA RD APT A
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-4481
Practice Address - Country:US
Practice Address - Phone:971-222-4323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-11493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty