Active NPI
Sarah Elizabeth Mulder
- Clinical Psychologist
- Huntsville, AL
National Provider Identifier
1104212109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2061
- Practice address
- 111 Longwood Dr SW
Huntsville, AL 35801-4522 - Phone
- (256) 534-8161
- Fax
- (256) 534-8161
- NPI assigned
- Apr 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2061 | AL | Primary |
Addresses
Primary practice location
111 Longwood Dr SW
Huntsville, AL 35801-4522
Mailing address
111 Longwood Drive SW
Huntsville, AL 35801
Phone (256) 534-8161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190218002072 | AL | Practitioner - Clinical Psychologist | 8527306539 | Practice locations: Huntsville, AL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2061 | AL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104212109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 LONGWOOD DRIVE SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "35801",
"telephone_number": "256-534-8161",
"fax_number": "256-534-7254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 LONGWOOD DR SW",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358014522",
"telephone_number": "256-534-8161",
"fax_number": "256-534-8161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULDER",
"first_name": "SARAH",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-07",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "2061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.