Basic Information
| Provider Information | |||||||||
| NPI: | 1265723415 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLS-JOHNSON | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | JEANETTE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 450964 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772450964 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812361135 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1941 EAST ROAD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134862700 | ||||||||
| FaxNumber: | 7134862721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2011 | ||||||||
| LastUpdateDate: | 09/20/2013 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 12/12/2011 | ||||||||
| NPIReactivationDate: | 09/20/2013 | ||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 10601 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.