Individual provider Active NPI

Edwin Thomas Mullavey Jr., P.C.C.

  • Mental Health Counselor
  • Steubenville, OH
National Provider Identifier
1306052253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E 0003333 Issued in OH
Practice address
380 Summit Ave
Tower Two Room Ten
Steubenville, OH 43952-2667
Phone
(740) 283-7860
Fax
(740) 283-7853
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

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
Mental Health Counselor 101YM0800X E 0003333 OH Primary

Addresses

Primary practice location

380 Summit Ave
Tower Two Room Ten
Steubenville, OH 43952-2667

Mailing address

380 Summit Avenue.
Tower Two Room Ten
Steubenville, OH 43952
Phone (740) 283-7860

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

State licenses

LicenseStateTypeSpecialty
E 0003333OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306052253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUMMIT AVENUE.",
            "address_2": "TOWER TWO ROOM TEN",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "43952",
            "telephone_number": "740-283-7860",
            "fax_number": "740-283-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SUMMIT AVE",
            "address_2": "TOWER TWO ROOM TEN",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522667",
            "telephone_number": "740-283-7860",
            "fax_number": "740-283-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLAVEY",
        "first_name": "EDWIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.C.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E  0003333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Steubenville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.