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NPI Code Detail

MEDICARE: SUZANNA MULLENNEAUX LMHC

MEDICARE: SUZANNA MULLENNEAUX LMHC
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
1101YM0800XMental Health Counselor00968IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1107314000OTHERIAIOWA PLAN

General Provider Information

NPI Number : 1134215197
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNA MULLENNEAUX LMHC
Provider Business Mailing Address
First Line : 301 W BURLINGTON AVE
Second Line :
City : FAIRFIELD
State : IA
Zip : 52556-3242
Country : US
Telephone Number : 641-472-1684
Fax Number : 641-472-4609
Provider Business Practice Location Address
First Line : 301 W BURLINGTON
Second Line :
City : FAIRFIELD
State : IA
Zip : 52556-3242
Country : US
Telephone Number : 641-472-5771
Fax Number : 641-472-1817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 05/13/2026

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Directions to “ SUZANNA MULLENNEAUX LMHC” Practice Location

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