Individual provider Active NPI

William Mills

  • Mental Health Counselor
  • Minneapolis, MN
National Provider Identifier
1104377878
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2826 Issued in MN
Practice address
1804 10TH Ave S
Minneapolis, MN 55404-2001
Phone
(612) 747-9561
NPI assigned
Oct 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303367
Mental Health Counselor 101YM0800X 2826 MN Primary

Addresses

Primary practice location

1804 10TH Ave S
Minneapolis, MN 55404-2001

Mailing address

1804 10TH Ave S
Minneapolis, MN 55404-2001
Phone (612) 747-9561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229003741 MN Practitioner - Mental Health Counselor 3870938707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians
Bhsi LLCGroup PAC ID 3274504816, 33 clinicians

Practice addresses (Care Compare)

Saint Paul, MN 55116
Phone (415) 360-3348

3460 Washington Dr
Suite 200
Eagan, MN 55122-4302
Phone (651) 769-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.a. CurrentSince Jan 1, 2025 Accepting new patients
Bhsi, LLC CurrentSince Jan 6, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

8059 W Preece Dr
Boise, ID 83704
Phone (208) 550-3112

3460 Washington Dr
Ste 200
Eagan, MN 55122
Phone (651) 232-3339

2136 Ford Pkwy
#5608
Saint Paul, MN 55116

2497 7th Ave E
Ste 101
Saint Paul, MN 55109
Phone (651) 769-6400

2497 7th Ave E
Ste 108
Saint Paul, MN 55109
Phone (651) 769-6437

2497 7th Ave E
Saint Paul, MN 55109
Phone (651) 387-2165

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1104377878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 10TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042001",
            "telephone_number": "612-747-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 10TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554042001",
            "telephone_number": "612-747-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "303367",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.