Individual
JEANEVRA LANISE MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
6135 PARK SOUTH DR STE 105, CHARLOTTE, NC 28210-3272
(704) 810-2700
Mailing address
6135 PARK SOUTH DR STE 105, CHARLOTTE, NC 28210-3272
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
20817
NC
106H00000X
Marriage & Family Therapist
Primary
3426
FL
Other
Enumeration date
09/13/2018
Last updated
01/14/2026
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