Provider Demographics
NPI:1457817520
Name:MCNEIL, AYANNA (LPC)
Entity Type:Individual
Prefix:
First Name:AYANNA
Middle Name:
Last Name:MCNEIL
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 1:305 STONERIDGE DR # B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-8046
Mailing Address - Country:US
Mailing Address - Phone:803-708-6014
Mailing Address - Fax:
Practice Address - Street 1:305 STONERIDGE DR # B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8046
Practice Address - Country:US
Practice Address - Phone:803-708-6014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7747101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1578807749Medicaid