| Mardi Mills Lcsw Llc | |
|
1601 116th Ave Ne Suite 104 Bellevue WA 98004-3010 | |
| (425) 453-2818 | |
| Not Available |
| Full Name | Mardi Mills Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1601 116th Ave Ne, Bellevue, Washington |
| Authorized Official Name and Position | Mardi Mills (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4254532818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mardi Mills Lcsw Llc 1601 116th Ave Ne Suite 104 Bellevue WA 98004-3010 Ph: (425) 453-2818 | Mardi Mills Lcsw Llc 1601 116th Ave Ne Suite 104 Bellevue WA 98004-3010 Ph: (425) 453-2818 |
| NPI Number | 1477984458 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 12/02/2013 |
| Medicare PECOS PAC ID | 4880976950 |
|---|---|
| Medicare Enrollment ID | O20170125001193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477984458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LW00004117 (Washington) | Primary |
| Provider Name | Mardi Mills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811052871 PECOS PAC ID: 5698057768 Enrollment ID: I20170125001234 |
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