Healthcare Provider Details

I. General information

NPI: 1467119867
Provider Name (Legal Business Name): LEIGH LUMPKIN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2614 DEVINE ST
COLUMBIA SC
29205-2410
US

IV. Provider business mailing address

2614 DEVINE ST
COLUMBIA SC
29205-2410
US

V. Phone/Fax

Practice location:
  • Phone: 803-702-8595
  • Fax:
Mailing address:
  • Phone: 803-702-8595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number898
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: