Active NPI
Clinton Wade Mills, MSW, RC
- Counselor
- Friday Harbor, WA
National Provider Identifier
1184827487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- RC00057541
- Practice address
- 555 McDonald St.
Friday Harbor, WA 98250 - Phone
- (360) 370-5867
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | RC00057541 | WA | Primary |
Addresses
Primary practice location
555 McDonald St.
Friday Harbor, WA 98250
Mailing address
555 McDonald St.
Friday Harbor, WA 98250
Phone (360) 370-5867
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00057541 | WA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184827487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 MCDONALD ST.",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "98250",
"telephone_number": "360-370-5867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 MCDONALD ST.",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "98250",
"telephone_number": "360-370-5867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLS",
"first_name": "CLINTON",
"middle_name": "WADE",
"name_prefix": "Mr.",
"credential": "MSW, RC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "RC00057541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Friday Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.