Healthcare Provider Details

I. General information

NPI: 1376429233
Provider Name (Legal Business Name): MEGAN MULLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N 300 W
CEDAR CITY UT
84721-3752
US

IV. Provider business mailing address

4664 N 2000 W
CEDAR CITY UT
84721-7189
US

V. Phone/Fax

Practice location:
  • Phone: 435-201-8685
  • Fax:
Mailing address:
  • Phone: 623-680-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14011796-6009
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: