Deborah R McMullen, PCC-SC, LICDC, LSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E 0002479 Issued in OH

Practice address

5727 Rowena Dr
Dayton, OH 45415-2445

Phone

(937) 361-4834

Fax

(937) 588-5877

NPI assigned

Dec 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advanced Therapeutic Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
  • NPI 1598746265
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1770568701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5727 ROWENA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152445",
            "telephone_number": "937-361-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5727 ROWENA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152445",
            "telephone_number": "937-361-4834",
            "fax_number": "937-588-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "DEBORAH",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PCC-SC, LICDC, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "021106",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S 0004990",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E 0002479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2272231",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylynn McMillam-Shaffer
• Cody H McMillan
• Sharon McMillan, BA
• Anna McMinn
• Amy Joann McMullen
• Jessie Ann McMullen, CRNA
• Donald William McMurray, CRNA
• Mitchell Neal McMurray, MD
• Emily McNamara
• Shannon Nichole McNary, LPN

• Professional Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Professional Counselor in Ohio

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