Healthcare Provider Details

I. General information

NPI: 1699699330
Provider Name (Legal Business Name): CHRISTOPHER EUGENE MULLINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 GUM BRANCH RD STE C
JACKSONVILLE NC
28540-6269
US

IV. Provider business mailing address

305 SPRING MAPLE WAY
RICHLANDS NC
28574-8496
US

V. Phone/Fax

Practice location:
  • Phone: 910-218-0006
  • Fax:
Mailing address:
  • Phone: 309-620-2861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23295
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: