Individual
MRS. MITZI D. WALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
105 CENTRAL AVE UNIT 4, GOOSE CREEK, SC 29445
(310) 874-0166
(843) 761-7308
Mailing address
448 BRICK KILN DR, SUMMERVILLE, SC 29483
(310) 874-0166
(843) 761-7308
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5771
SC
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5771
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA COUNSELOR
BH SOCIAL SERVICE
MA
Enumeration date
06/14/2012
Last updated
12/23/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us