Provider Demographics
NPI:1821819566
Name:MILLIGAN, MELISSA RENEE (LPCA)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:RENEE
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 CROSSVINE WAY
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6889
Mailing Address - Country:US
Mailing Address - Phone:864-401-4076
Mailing Address - Fax:
Practice Address - Street 1:108 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-3518
Practice Address - Country:US
Practice Address - Phone:803-667-4697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional