Connie Laverne McMullen, MS LPC NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1724 Issued in OR

Practice address

10260 SW Greenburg Rd
473
Portland, OR 97223-5500

Phone

(503) 544-8221

Fax

(503) 246-4446

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1972712149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8193 SW 82ND PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236995",
            "telephone_number": "503-244-6616",
            "fax_number": "503-246-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 SW GREENBURG RD",
            "address_2": "473",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235500",
            "telephone_number": "503-544-8221",
            "fax_number": "503-246-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "CONNIE",
        "middle_name": "LAVERNE",
        "name_prefix": "Ms.",
        "credential": "MS LPC NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": "55781",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Rae McMinn Kaigler, CADC I
• James Sheppard Bruce McMinn, RN
• Rachel Anne McMorris
• John Barton McMullan Jr, M.D.
• Lori Lee McMullan, M.D.
• Kelly McMullen, LMT
• Melissa B McMullen, D.C.
• Molly McMullen
• Shelly Lynn McMullen, BA QMHA
• Nicole Lee McMullin, LCSW

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.