Individual provider Active NPI

Patrick N Mulhall, PH.D,LCSW,PA

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1154404663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW0004441 Issued in FL
Practice address
3475 Sheridan St
Suite 312
Hollywood, FL 33021-3663
Phone
(954) 894-8024
Fax
(954) 894-8094
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW0004441 FL Primary

Addresses

Primary practice location

3475 Sheridan St
Suite 312
Hollywood, FL 33021-3663

Mailing address

3475 Sheridan St
Suite 312
Hollywood, FL 33021-3663
Phone (954) 894-8024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110610000521 FL Practitioner - Clinical Social Worker 9032396130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3475 Sheridan St
Suite 312
Hollywood, FL 33021-3600

3475 Sheridan St
Suite 312
Hollywood, FL 33021-3660
Phone (954) 894-8024

3475 Sheridan St
Suite 312
Hollywood, FL 33021-3663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SW0004441FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick Mulhall, PH.D,LCSW,PA Clinical CurrentSince Aug 11, 2010 Accepting new patients

Locations

3475 Sheridan St
Ste 312
Hollywood, FL 33021
Phone (954) 894-8024

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154404663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 SHERIDAN ST",
            "address_2": "SUITE 312",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213663",
            "telephone_number": "954-894-8024",
            "fax_number": "954-894-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 SHERIDAN ST",
            "address_2": "SUITE 312",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213663",
            "telephone_number": "954-894-8024",
            "fax_number": "954-894-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHALL",
        "first_name": "PATRICK",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PH.D,LCSW,PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0004441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.