Mullally, Jeanne

Mullally, Jeanne is an individual health care provider with primary practice located at 104 4Th Ave Sw Room 238, Albany OR 97321-2804. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Mullally, Jeanne can be contacted via phone (541) 967-3819.

Contact Information

Primary practice address
104 4Th Ave Sw Room 238 Albany OR 97321-2804
Phone: (541) 967-3819
Fax: (541) 967-7259
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X L2225 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2225 Oregon

Profile Details

NPI number 1528515566
LBN Legal business name Mullally, Jeanne
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2016
Last updated Mar 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528515566 NPPES
Oregon MEDICAID 101279

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