Provider Demographics
NPI:1316548316
Name:MCNINCH, DIANE M (LPC, LPCS-C)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:MCNINCH
Suffix:
Gender:F
Credentials:LPC, LPCS-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CAROLINA CIR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-5104
Mailing Address - Country:US
Mailing Address - Phone:864-992-8733
Mailing Address - Fax:
Practice Address - Street 1:130 WHITEFORD WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-5800
Practice Address - Country:US
Practice Address - Phone:803-808-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health