Healthcare Provider Details

I. General information

NPI: 1609747922
Provider Name (Legal Business Name): ALYSSA MULCAHY BSN, RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 BATIK WAY
STEPHENSON VA
22656
US

IV. Provider business mailing address

122 BATIK WAY
STEPHENSON VA
22656
US

V. Phone/Fax

Practice location:
  • Phone: 540-247-1057
  • Fax:
Mailing address:
  • Phone: 540-247-1057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001256015
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-318888
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: