Healthcare Provider Details

I. General information

NPI: 1962000869
Provider Name (Legal Business Name): AMANDA MULLIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 S CLAIRBORNE RD STE 225
OLATHE KS
66062-1790
US

IV. Provider business mailing address

815 S CLAIRBORNE RD STE 225
OLATHE KS
66062-1790
US

V. Phone/Fax

Practice location:
  • Phone: 913-549-0442
  • Fax:
Mailing address:
  • Phone: 913-549-0442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3455
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: