Provider Demographics
NPI:1598648677
Name:MCMILLIAN, CELINA MONIQUE
Entity type:Individual
Prefix:MS
First Name:CELINA
Middle Name:MONIQUE
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 DEAN CT
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:GA
Mailing Address - Zip Code:30179-5490
Mailing Address - Country:US
Mailing Address - Phone:706-399-2764
Mailing Address - Fax:
Practice Address - Street 1:304 DEAN CT
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:GA
Practice Address - Zip Code:30179-5490
Practice Address - Country:US
Practice Address - Phone:706-399-2764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0097321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical