Individual provider · Type 1 NPI

Mitzi D. Wallen, LPC

Professional Counselor · Goose Creek, SC

NPI number 1629330667 Active

Practice location

105 Central Ave Unit 4
Goose Creek, SC 29445

Call (310) 874-0166 Map

Fax (843) 761-7308

Mailing address

448 Brick Kiln Dr
Summerville, SC 29483

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Mental Health Counselor 101YM0800X5771 (SC)
Professional Counselor Primary 101YP2500X5771 (SC)

Professional Counselor: Definition to come...

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About NPI 1629330667

Mitzi D. Wallen, LPC's National Provider Identifier is 1629330667, issued on Jun 14, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Goose Creek, SC. The record was last updated on Dec 23, 2024.