Individual provider Active NPI

Austin Kay Mullen

  • Social Worker
  • Tucson, AZ
National Provider Identifier
1861982274
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LM17807 Issued in ME
Practice address
3601 S 6TH Ave
Tucson, AZ 85723-0001
Phone
(520) 792-1450
NPI assigned
May 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LM17807 ME Primary

Addresses

Primary practice location

3601 S 6TH Ave
Tucson, AZ 85723-0001

Mailing address

4111 N Flowing Wells Rd Unit 15101
Tucson, AZ 85705-6340
Phone (520) 867-0030

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LM17807MEMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1861982274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N FLOWING WELLS RD UNIT 15101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857056340",
            "telephone_number": "520-867-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S 6TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857230001",
            "telephone_number": "520-792-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "AUSTIN",
        "middle_name": "KAY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-11",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LM17807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.