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NPI Code Detail

MEDICARE: HENRY MULBAH MS, CRC

MEDICARE: HENRY MULBAH MS, CRC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor225497IL

General Provider Information

NPI Number : 1063355998
Entity Type Code : Individual
Provider Name (Legal Business Name) : HENRY MULBAH MS, CRC
Provider Business Mailing Address
First Line : 4801 VETERANS DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-252-1670
Fax Number :
Provider Business Practice Location Address
First Line : 4801 VETERANS DR
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-252-1670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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