Provider Demographics
NPI:1306033998
Name:MCMILLON, CORINNA S (LPC)
Entity Type:Individual
Prefix:
First Name:CORINNA
Middle Name:S
Last Name:MCMILLON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 DOMINIQUE ST
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2854
Mailing Address - Country:US
Mailing Address - Phone:910-322-1479
Mailing Address - Fax:
Practice Address - Street 1:2014 HOPE MILLS RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4225
Practice Address - Country:US
Practice Address - Phone:910-425-6136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional