Individual provider Active NPI

Carol S Mills, PHD

  • Clinical Psychologist
  • Beachwood, OH
National Provider Identifier
1548370042
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3734 Issued in OH
Practice address
3619 Park East Dr
Suite 313
Beachwood, OH 44122-4330
Phone
(216) 591-0500
Fax
(216) 591-0550
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3734 OH Primary

Addresses

Primary practice location

3619 Park East Dr
Suite 313
Beachwood, OH 44122-4330

Mailing address

3619 Park East Dr
Suite 313
Beachwood, OH 44122-4330
Phone (216) 591-0500

Other identifiers 1

IdentifierTypeStateIssuer
0210542MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040326000664 OH Practitioner - Clinical Psychologist 4082506886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Humanistic Counseling Center LLCGroup PAC ID 9335044619, 28 clinicians

Practice addresses (Care Compare)

37231 Colorado Ave
Avon, OH 44011-1527
Phone (216) 839-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3734OHMDClinical Psychologist
1058OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Transitions, Inc Clinical PastSince Apr 1, 1995 Accepting new patients

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548370042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 313",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-591-0500",
            "fax_number": "216-591-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 313",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-591-0500",
            "fax_number": "216-591-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLS",
        "first_name": "CAROL",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210542",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.