Individual
RANDY LEE MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC PLLC
Contact information
Practice address
825 MAJESTIC CT UNIT 8, GASTONIA, NC 28054-5186
(704) 813-2649
(704) 868-9948
Mailing address
1604 ELKHART CIR, GASTONIA, NC 28054-7745
(704) 813-2649
(704) 867-6206
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
642
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103103
—
NC
01
—
61302
BCBS
NC
Enumeration date
09/29/2005
Last updated
11/30/2010
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