Individual provider Active NPI

Mani Mullen, CRC # 00002984

  • Mental Health Counselor
  • Queens Village, NY
National Provider Identifier
1922464957
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
7925 Winchester Blvd
Queens Village, NY 11427-2128
Phone
(718) 464-7500
Fax
(718) 264-5043
NPI assigned
Jan 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

7925 Winchester Blvd
Queens Village, NY 11427-2128

Mailing address

7925 Winchester Blvd
Queens Village, NY 11427-2128
Phone (718) 464-7500

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

NPI Registry JSON

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1922464957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-464-7500",
            "fax_number": "718-264-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-464-7500",
            "fax_number": "718-264-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "MANI",
        "credential": "CRC # 00002984",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.