MS. MARY DARLENE MILLICENT LICSW NPI 1649547589

NPI Information

NPI: 1649547589
Provider Name: MS. MARY DARLENE MILLICENT, LICSW
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
520 NW 5TH ST
BRAINERD, MN
ZIP 56401
Phone: (218) 829-3235
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MS. Mary Darlene Millicent, LICSW is a mental health counselor in Brainerd, MN. MS. Mary Darlene Millicent, LICSW NPI is 1649547589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

520 NW 5TH ST
BRAINERD, MN
ZIP 56401-902
Phone: (218) 829-3235

The enumeration date for this NPI number is 11/21/2011 and was last updated on 11/21/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	16030	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00000000	OTHER		NONE-PENDING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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