Provider Demographics
NPI:1265216055
Name:MACKINS, FELICIA CAMERON (M ED, LPCA, GCDF)
Entity type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:CAMERON
Last Name:MACKINS
Suffix:
Gender:F
Credentials:M ED, LPCA, GCDF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-8659
Mailing Address - Country:US
Mailing Address - Phone:803-389-7623
Mailing Address - Fax:
Practice Address - Street 1:1420 EBENEZER RD STE 101
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2774
Practice Address - Country:US
Practice Address - Phone:803-627-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7949101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor