Provider Demographics
NPI:1053484733
Name:MULHOLLAND, CHITA (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHITA
Middle Name:
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MRS
Other - First Name:CHAUNITA
Other - Middle Name:KATHERINE
Other - Last Name:MULHOLLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, CSAT
Mailing Address - Street 1:1000 S MAIN ST
Mailing Address - Street 2:STE. 260
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7513
Mailing Address - Country:US
Mailing Address - Phone:817-912-0313
Mailing Address - Fax:817-912-0330
Practice Address - Street 1:1000 S MAIN ST
Practice Address - Street 2:STE. 260
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7513
Practice Address - Country:US
Practice Address - Phone:817-912-0313
Practice Address - Fax:817-912-0330
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX16-1645342OtherTAX ID
TX17962OtherLICENSED PROFESSIONAL COUNSELOR BOARD