Provider Demographics
NPI:1770777435
Name:MILLIGAN, NANCY LYNN (ED S, LPC (NC))
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:ED S, LPC (NC)
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:FISHER-MILLIGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ED S, LPC (NC)
Mailing Address - Street 1:361 CHAMPION CT
Mailing Address - Street 2:A-7
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-2628
Mailing Address - Country:US
Mailing Address - Phone:910-457-9345
Mailing Address - Fax:
Practice Address - Street 1:361 CHAMPION CT
Practice Address - Street 2:A-7
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-2628
Practice Address - Country:US
Practice Address - Phone:910-457-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC59306OtherBC/BS STATE OF NC