Active NPI
Jennifer Michelle Mullen, MS, LPC
- Professional Counselor
- Scottsdale, AZ
National Provider Identifier
1255808390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-17619
- Practice address
- 7301 E 2ND St
Scottsdale, AZ 85251-5600 - Phone
- (480) 882-4545
- NPI assigned
- Oct 26, 2018
- Reactivated
- Nov 5, 2018
- Last updated
- Dec 16, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-17619 | AZ | Primary |
Addresses
Primary practice location
7301 E 2ND St
Scottsdale, AZ 85251-5600
Mailing address
7301 E 2ND St
Scottsdale, AZ 85251-5600
Phone (480) 882-4545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC-17619 | Other | AZ | LICENSED PROFESSIONAL COUNSELOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-17619 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Anesthesiology Consultants, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Phoenix, AZ
- NPI 1285660704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639612800000",
"number": "1255808390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 E 2ND ST",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852515600",
"telephone_number": "480-882-4545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 E 2ND ST",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852515600",
"telephone_number": "480-882-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "JENNIFER",
"middle_name": "MICHELLE",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-26",
"last_updated": "2021-12-16",
"certification_date": "2021-12-16",
"deactivation_date": "2018-10-26",
"reactivation_date": "2018-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-17619",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROFESSIONAL COUNSELOR",
"identifier": "LPC-17619",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.