Eyerusalem Mulatu, MBA,LCDC, LPC-A

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

83045 Issued in TX

Practice address

1400 N Coit Rd Ste 302
McKinney, TX 75071-6656

Phone

(833) 351-8255

NPI assigned

Jan 12, 2021

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

State licenses

Practice roles

Locations

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.

• MCCD FL Psychiatry Services PA

  dba Talkiatry

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457

  TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1710576079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N COIT RD STE 302",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716656",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12655 W Houston Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770822756",
            "country_code": "US",
            "telephone_number": "832-693-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4652 Cornish St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770071943",
            "country_code": "US",
            "telephone_number": "832-693-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12655 W Houston Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770822756",
            "country_code": "US",
            "telephone_number": "832-693-4857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULATU",
        "first_name": "EYERUSALEM",
        "credential": "MBA,LCDC, LPC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "83045",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "83045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pingmd",
            "affiliation": "N",
            "address_1": "4652 Cornish St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770071943",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PingMD",
            "affiliation": "N",
            "address_1": "4652 Cornish St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770071943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Wairimu Muchungi
• Mudallalah LLC
• Michelle Mudge-Riley
• Erica Mueller, DC
• Elizabeth Anne Mugati
• Timothy Edward Mulberry
• Jene C Mullenger
• Katie Mullenix
• Brittany Muller, BCBA
• Madelyn Mullinax

• Professional Counselor in McKinney, TX
• Providers in McKinney, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.