Provider Demographics
NPI:1376884551
Name:MULLIS, LENNIE SCHLAGER (LPCI)
Entity Type:Individual
Prefix:MRS
First Name:LENNIE
Middle Name:SCHLAGER
Last Name:MULLIS
Suffix:
Gender:F
Credentials:LPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 LOFTY PINE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2040
Mailing Address - Country:US
Mailing Address - Phone:803-781-4437
Mailing Address - Fax:
Practice Address - Street 1:1002 LOFTY PINE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2040
Practice Address - Country:US
Practice Address - Phone:803-781-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5741101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional