Provider Demographics
NPI:1619986007
Name:MULLEN, PATRICIA LYNNE (LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNNE
Last Name:MULLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 MECHANICSVILLE TPKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-3698
Mailing Address - Country:US
Mailing Address - Phone:804-270-1124
Mailing Address - Fax:
Practice Address - Street 1:6501 MECHANICSVILLE TPKE
Practice Address - Street 2:SUITE 105
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3698
Practice Address - Country:US
Practice Address - Phone:804-270-1124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA89619OtherSENTARA PROVIDER NUMBER
VA288225OtherANTHEM PROVIDER NUMBER
VA397116OtherMAMSI PROVIDER NUMBER
VA5414695Medicaid