Healthcare Provider Details

I. General information

NPI: 1316874357
Provider Name (Legal Business Name): HIRAM MULLINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1948 N LIMESTONE ST
SPRINGFIELD OH
45503-2648
US

IV. Provider business mailing address

340 MOUNT JOY ST
SPRINGFIELD OH
45505-2623
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax: 800-480-7578
Mailing address:
  • Phone: 326-216-1880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.195799
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: