Individual
AMANDA GABRIELLE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
718 DUPONT RD, CHARLESTON, SC 29407-5729
(843) 944-2283
(847) 607-9763
Mailing address
718 DUPONT RD, CHARLESTON, SC 29407-5729
(843) 944-2283
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150118103
IL
1041C0700X
Clinical Social Worker
Primary
18195
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
12/29/2020
Last updated
11/03/2025
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