Provider Demographics
NPI:1093077026
Name:MULLEN, CAROLINE SR (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:MULLEN
Suffix:SR
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-0228
Mailing Address - Country:US
Mailing Address - Phone:347-420-8459
Mailing Address - Fax:
Practice Address - Street 1:1 BLUE HILL PLZ LBBY LVL
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-3111
Practice Address - Country:US
Practice Address - Phone:347-420-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0486051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical