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NPI Code Detail

MEDICARE: JOELI MULLIGAN LPC-A

MEDICARE: JOELI MULLIGAN LPC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor7947SC

General Provider Information

NPI Number : 1154059590
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOELI MULLIGAN LPC-A
Provider Business Mailing Address
First Line : 181 MADISON PARK DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-7912
Country : US
Telephone Number : 803-212-8087
Fax Number :
Provider Business Practice Location Address
First Line : 1154 SUNNYSIDE DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-3387
Country : US
Telephone Number : 803-667-4697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2022
Last Update Date : 08/12/2022

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Directions to “ JOELI MULLIGAN LPC-A” Practice Location

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