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NPI Code Detail

MEDICARE: MR. CRAIG ALLEN MULLINS M.A., L.P.C.-MH

MEDICARE: MR. CRAIG ALLEN MULLINS M.A., L.P.C.-MH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor30550SD
2101YP2500XProfessional CounselorLPC.0011682CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033545082
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CRAIG ALLEN MULLINS M.A., L.P.C.-MH
Provider Business Mailing Address
First Line : 4447 S CANYON RD STE 5
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-1889
Country : US
Telephone Number : 605-391-8882
Fax Number : 605-385-0035
Provider Business Practice Location Address
First Line : 4447 S CANYON RD STE 5
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-1889
Country : US
Telephone Number : 605-391-8882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2013
Last Update Date : 01/17/2025

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