Individual provider Active NPI

Michael E Mullin, L.I.S.W.

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1841400595
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0002000 Issued in OH
Practice address
1708 Southpoint Dr
Cleveland, OH 44109-1911
Phone
(216) 787-0500
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0002000 OH Primary

Addresses

Primary practice location

1708 Southpoint Dr
Cleveland, OH 44109-1911

Mailing address

6140 S Broadway
11TH FL Attn Mary Kyle
Lorain, OH 44053-3821
Phone (614) 466-9930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients

Organizations & group practices 2

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1841400595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "address_2": "11TH FL ATTN MARY KYLE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "614-466-9930",
            "fax_number": "614-644-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 SOUTHPOINT DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091911",
            "telephone_number": "216-787-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0002000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.