Healthcare Provider Details

I. General information

NPI: 1396219150
Provider Name (Legal Business Name): MUELLER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1784 BARTON AVE STE 9
WEST BEND WI
53090-5418
US

IV. Provider business mailing address

1784 BARTON AVE STE 9
WEST BEND WI
53090-5418
US

V. Phone/Fax

Practice location:
  • Phone: 651-497-1909
  • Fax:
Mailing address:
  • Phone: 651-497-1909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MITCHELL LEE MUELLER
Title or Position: OWNER/THERAPIST
Credential: MPS, LPC, LADC, LPCC
Phone: 651-497-1909