Individual provider Active NPI

Grace Mullen, PSYCHOLOGY INTERN

  • Mental Health Counselor
  • Elyria, OH
National Provider Identifier
1942777362
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
312 3Rd St
Elyria, OH 44035-5618
Phone
(440) 323-5707
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH
Community Health Worker 172V00000X OH
Community/Behavioral Health Agency 251S00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

312 3Rd St
Elyria, OH 44035-5618

Mailing address

312 3Rd St Entrance Holly Lane
Elyria, OH 44035-1217
Phone (440) 323-5707

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling and Growth Center Community/Behavioral Health CurrentSince Mar 6, 2022 Accepting new patients
Pathways Counseling and Growth Center Community/Behavioral Health PastSince Mar 6, 2022 Accepting new patients

Locations

312 3rd St
Elyria, OH 44035
Phone (440) 323-5707

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathwayscounselingcenter/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1942777362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 3RD ST ENTRANCE HOLLY LANE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440351217",
            "telephone_number": "440-323-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 3RD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355618",
            "telephone_number": "440-323-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "GRACE",
        "credential": "PSYCHOLOGY INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.