Provider Demographics
NPI:1154059590
Name:MULLIGAN, JOELI (LPC-A)
Entity type:Individual
Prefix:
First Name:JOELI
Middle Name:
Last Name:MULLIGAN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MADISON PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7912
Mailing Address - Country:US
Mailing Address - Phone:803-212-8087
Mailing Address - Fax:
Practice Address - Street 1:1154 SUNNYSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-3387
Practice Address - Country:US
Practice Address - Phone:803-667-4697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional