Provider Demographics
NPI:1942516299
Name:MULKEY, WILLIAM LOUIS (MA, NCC, LPC, LPCS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LOUIS
Last Name:MULKEY
Suffix:
Gender:M
Credentials:MA, NCC, LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 BRIAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3003
Mailing Address - Country:US
Mailing Address - Phone:864-915-8726
Mailing Address - Fax:
Practice Address - Street 1:880 S PLEASANTBURG DR STE 4F
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-915-8726
Practice Address - Fax:888-600-7749
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5673101YP2500X
SC4975101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1033Medicaid
SCGP5592Medicaid