Provider Demographics
NPI:1023160660
Name:MILLS, CAROL CHAMBERS (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:CHAMBERS
Last Name:MILLS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 N 21ST ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-3707
Mailing Address - Country:US
Mailing Address - Phone:717-303-0444
Mailing Address - Fax:717-303-0108
Practice Address - Street 1:355 N 21ST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-3707
Practice Address - Country:US
Practice Address - Phone:717-303-0444
Practice Address - Fax:717-303-0108
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008182L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA467319OtherVALUE OPTIONS
PA1175528OtherCIGNA BEHAVIORAL HEALTH
PA61-23547OtherUNITED HEALTHCARE
PA50026450OtherCAPITAL BLUE CROSS
PA50026450OtherCAPITAL BLUE CROSS
PAMI809210Medicare ID - Type Unspecified