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NPI Code Detail

MEDICARE: MS. SUSAN CAROLYN MULLINS LMHC

MEDICARE: MS. SUSAN CAROLYN MULLINS 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 CounselorMH2980FL

General Provider Information

NPI Number : 1720145824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN CAROLYN MULLINS LMHC
Provider Business Mailing Address
First Line : 2106 W CASS ST
Second Line :
City : TAMPA
State : FL
Zip : 33606-1234
Country : US
Telephone Number : 813-205-4900
Fax Number :
Provider Business Practice Location Address
First Line : 2106 W CASS ST
Second Line :
City : TAMPA
State : FL
Zip : 33606-1234
Country : US
Telephone Number : 813-205-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/21/2022

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