Dominique Antawn Mills, LPC-R

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0704014275 Issued in VA

Practice address

247 McLaws Cir
Williamsburg, VA 23185-5660

Phone

(757) 253-0111

NPI assigned

Apr 6, 2022

Last updated

Apr 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Ascension Psychiatric Services LLC

  • Psychiatry Physician
  • Hopewell, VA
  • NPI 1184471898
  Medicare reassignment NPD
• Bacon Street Youth and Family Services

  • Community/Behavioral Health Agency
  • Williamsburg, VA
  • NPI 1144376112

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1164163655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 MCLAWS CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855660",
            "telephone_number": "757-253-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 MCLAWS CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855660",
            "telephone_number": "757-253-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "DOMINIQUE",
        "middle_name": "ANTAWN",
        "credential": "LPC-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0709024174",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0704014275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmills@baconstreet.org",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "address_1": "247 McLaws Cir",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231855660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Francois Miller, MD
• Marcia Lou Miller, MS PT CHT
• Mary T Millis, PTA
• Mills Speech Therapy
• Coty Mills, LCSW
• Katherine Mills
• Kristie Marlene Mishler, PHARM.D.
• Jennifer Mishoe, LMT
• Mission Mind Wellness, LLC
• Shawn Anthony Mitchell, DDS

• Professional Counselor in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.