Provider Demographics
NPI:1093325029
Name:MUSTAFA, ALANDRIA (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:ALANDRIA
Middle Name:
Last Name:MUSTAFA
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 DORCHESTER RD APT 911
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7378
Mailing Address - Country:US
Mailing Address - Phone:954-993-4270
Mailing Address - Fax:
Practice Address - Street 1:100A CENTRAL AVE STE 206
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2979
Practice Address - Country:US
Practice Address - Phone:954-993-4270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7397101YM0800X
FLMH16134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health