Healthcare Provider Details

I. General information

NPI: 1265298053
Provider Name (Legal Business Name): DOROTHY LEIGHANN MULLINNIX MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 NE MAIN ST
SIMPSONVILLE SC
29681-2041
US

IV. Provider business mailing address

11 PARIS VIEW DR
TRAVELERS REST SC
29690-1514
US

V. Phone/Fax

Practice location:
  • Phone: 864-538-6906
  • Fax:
Mailing address:
  • Phone: 864-982-0490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11858
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: