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NPI Code Detail

MEDICARE: MS. STEPHANIE ANN MULLIS LMHC

MEDICARE: MS. STEPHANIE ANN MULLIS 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 CounselorMH9023FL

General Provider Information

NPI Number : 1831226323
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE ANN MULLIS LMHC
Provider Business Mailing Address
First Line : PO BOX 748519
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8519
Country : US
Telephone Number : 904-376-3800
Fax Number : 904-376-3998
Provider Business Practice Location Address
First Line : 4844 DEER LAKE DR W STE 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-4406
Country : US
Telephone Number : 904-376-3800
Fax Number : 904-390-7431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 08/05/2022

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Directions to “ MS. STEPHANIE ANN MULLIS LMHC” Practice Location

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