Carolyn C Mullas, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.010794 Issued in IL

Practice address

5816 Primrose Ave
Lisle, IL 60532-2746

Phone

(248) 672-7014

NPI assigned

Feb 18, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carolyn Lea Campbell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Mullas Counseling LLC

  • Mental Health Counselor
  • Troy, MI
  • NPI 1396603106
  NPD Authorized official
• Catawba Mental Health Center

  • Community/Behavioral Health Agency
  • Rock Hill, SC
  • NPI 1831375021
  NPD (past)

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1730401795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 PRIMROSE AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322746",
            "telephone_number": "248-672-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 PRIMROSE AVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322746",
            "telephone_number": "248-672-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLAS",
        "first_name": "CAROLYN",
        "middle_name": "C",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "CAMPBELL",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Lisle, IL
• Providers in Lisle, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.