Provider Demographics
NPI:1174930077
Name:MCMILLEN, DENIKA (LCSW)
Entity type:Individual
Prefix:MS
First Name:DENIKA
Middle Name:
Last Name:MCMILLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 W 97TH PL
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2651
Mailing Address - Country:US
Mailing Address - Phone:773-972-9601
Mailing Address - Fax:
Practice Address - Street 1:2815 W 97TH PL
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2651
Practice Address - Country:US
Practice Address - Phone:773-972-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-13
Last Update Date:2014-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0107521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical