Individual provider Active NPI

Michael G Mullen, LMHC

  • Mental Health Counselor
  • Oswego, NY
National Provider Identifier
1629269758
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000675 Issued in NY
Practice address
5 W Cayuga St
Oswego, NY 13126-2031
Phone
(315) 342-9255
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 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 000675 NY Primary

Addresses

Primary practice location

5 W Cayuga St
Oswego, NY 13126-2031

Mailing address

3066 State Route 48
Oswego, NY 13126-5733
Phone (315) 591-2408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 18, 2024 through Jan 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000675NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Mental Health Counseling Services, PLLC Mental Health 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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1629269758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 STATE ROUTE 48",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131265733",
            "telephone_number": "315-591-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W CAYUGA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262031",
            "telephone_number": "315-342-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.