Provider Demographics
NPI:1952033342
Name:MCMILLIAN, SHDAVIA ASHA (LPC)
Entity type:Individual
Prefix:
First Name:SHDAVIA ASHA
Middle Name:
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ASHA
Other - Middle Name:
Other - Last Name:MCMILLIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:710 N WINDOWPANE WAY
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8979
Mailing Address - Country:US
Mailing Address - Phone:864-529-4444
Mailing Address - Fax:
Practice Address - Street 1:710 N WINDOWPANE WAY
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8979
Practice Address - Country:US
Practice Address - Phone:864-334-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-26
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health