Mullen, John Thomas

Mullen, John Thomas is an individual health care provider with primary practice located at 913 E 26Th St Ste 503 , Minneapolis MN 55404-4515. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Mullen, John Thomas can be contacted via phone (612) 863-5100.

Contact Information

Primary practice address
913 E 26Th St Ste 503 Minneapolis MN 55404-4515
Phone: (612) 863-5100
Fax: (612) 863-5109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP4239 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4239 Minnesota

Profile Details

NPI number 1700850823
LBN Legal business name Mullen, John Thomas
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Nov 10th, 2020 - about 5 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 1700850823 NPPES
Minnesota MEDICAID 604909500

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