Provider Demographics
NPI:1285059709
Name:MCGINNIS, NINA (LPC)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 N 7TH AVE APT 503
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-3466
Mailing Address - Country:US
Mailing Address - Phone:601-425-5052
Mailing Address - Fax:
Practice Address - Street 1:409 W OAK ST STE 401A
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4102
Practice Address - Country:US
Practice Address - Phone:601-283-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional