| Gina M. Mills, Lcsw, Llc | |
| 
					329 Ledge Rd Dayville CT 06241-1923  | |
| (860) 516-5672 | |
| (888) 233-4694 | 
| Full Name | Gina M. Mills, Lcsw, Llc | 
|---|---|
| Speciality | Social Worker | 
| Location | 329 Ledge Rd, Dayville, Connecticut | 
| Authorized Official Name and Position | Gina Michelle Mills (THERAPIST/OWNER) | 
| Authorized Official Contact | 8605165672 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Gina M. Mills, Lcsw, Llc Po Box 80 Dayville CT 06241-0080 Ph: (860) 516-5672  | Gina M. Mills, Lcsw, Llc 329 Ledge Rd Dayville CT 06241-1923 Ph: (860) 516-5672  | 
| NPI Number | 1619399672 | 
|---|---|
| Provider Enumeration Date | 01/10/2014 | 
| Last Update Date | 01/04/2021 | 
| Certification Date | 01/04/2021 | 
| Medicare PECOS PAC ID | 2466751201 | 
|---|---|
| Medicare Enrollment ID | O20160429001267 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1619399672 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 8387 (Connecticut) | Primary | 
| Provider Name | Gina M Mills | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1972822997 PECOS PAC ID: 0446559181 Enrollment ID: I20160429001448  | 
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