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General NPI Number Information
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NPI Number | 1265298053
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Entity Type | Individual
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Provider Name | LEIGHANN MULLINNIX MA, LPC-A
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Gender | Female
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 887 NE MAIN ST
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2041
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Country | US
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Telephone | 864-538-6906
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Fax |
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Provider Business Mailing Address
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Address Line | 11 PARIS VIEW DR
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City | TRAVELERS REST
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State | SC
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Zip | 29690-1514
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Country | US
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Telephone | 864-982-0490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8864
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License Number State | SC
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