Jawan Mullen Sr., CDAC INTERN

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

08256-1 Issued in NV

Practice address

5940 Moondance CT
Henderson, NV 89011-4921

Phone

(703) 269-7616

NPI assigned

Nov 8, 2017

Last updated

May 28, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1124531421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 MOONDANCE CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114921",
            "telephone_number": "703-269-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 MOONDANCE CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890114921",
            "telephone_number": "703-269-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JAWAN",
        "name_suffix": "Sr.",
        "credential": "CDAC INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-08",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "08256-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Ali Syed MD PC
• Renee Muhammad
• Lindsay Muir
• Kamalini Mukerjee, RD
• Brandon Mukes
• Suzette Mullen
• Andrea Nicole Mulligan, DPT
• Christina M Mulloy-Groh, PT
• Multigenerational Home Modifications LLC
• John Mulzet

• Addiction (Substance Use Disorder) Counselor in Henderson, NV
• Providers in Henderson, NV by specialty
• Addiction (Substance Use Disorder) Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.