Basic Information
Provider Information
NPI: 1043791460
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLINGTON
FirstName: CAROLINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PLPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MILLINGTON
OtherFirstName: CALLIE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PLPC
OtherLastNameType: 5
Mailing Information
Address1: 906 MONTEGUT ST
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701177202
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 115 KEATING DR
Address2:  
City: BELLE CHASSE
State: LA
PostalCode: 700371629
CountryCode: US
TelephoneNumber: 5043935750
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/23/2018
LastUpdateDate: 08/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X7550LAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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