person
Mrs. Mitzi D. Wallen, LPC
Professional Counselor in Goose Creek, South Carolina
NPI 1629330667

Mitzi D. Wallen is a Professional Counselor based in Summerville, SC and is specialized in Professional. Mitzi D. Wallen practices in Goose Creek, SC and has the professional credentials of LPC. The NPI Number for Mitzi D. Wallen is 1629330667 and holds a License No. (South Carolina).

The current practice location address for Mitzi D. Wallen is 105 Central Ave Unit 4, Goose Creek, SC and can be reached out via phone at 310-874-0166 and via fax at 843-761-7308.

Location: 105 Central Ave Unit 4, Goose Creek, SC, 29483
person
Provider Profile Details
NPI Number
1629330667
Provider Name
Mitzi D. Wallen
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
105 Central Ave Unit 4, Goose Creek, SC, 29483
Phone Number
310-874-0166
Fax Number
843-761-7308
Provider Enumeration Date
06/14/2012
Last Update Date
01/18/2025
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Provider's Legacy Identifiers
Identifier Type State Issuer
MA COUNSELOR 01 MA BH SOCIAL SERVICE
institution
Provider Business Practice Location Address Details
Address
105 Central Ave Unit 4
City
State
Zip
29445
Phone Number
310-874-0166
Fax Number
843-761-7308
person
Provider Business Mailing Address Details
Address
105 Central Ave Unit 4
City
State
Zip
29445
Phone Number
310-874-0166
Fax Number
843-761-7308
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
5771 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
()
Definition
Definition to come...
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