Individual provider Active NPI

Jodi Weinstein Mullen, PHD, NCC, RPT, LMHC

  • Mental Health Counselor
  • Oswego, NY
National Provider Identifier
1649375312
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000518 Issued in NY
Practice address
5 W Cayuga St
Oswego, NY 13126-2031
Phone
(315) 342-9255
Fax
(186) 632-3661
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 000518 NY Primary

Addresses

Primary practice location

5 W Cayuga St
Oswego, NY 13126-2031

Mailing address

5 W Cayuga St
Oswego, NY 13126-2031
Phone (315) 342-9255

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000518NYMDMarriage & Family Therapist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1649375312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W CAYUGA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262031",
            "telephone_number": "315-342-9255",
            "fax_number": "186-632-3661"
        },
        {
            "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",
            "fax_number": "186-632-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JODI",
        "middle_name": "WEINSTEIN",
        "name_prefix": "Dr.",
        "credential": "PHD, NCC, RPT, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.