Provider Demographics
NPI:1114988615
Name:MULLIN, CARLA JOY (MSW LCSW CAP SAP)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:JOY
Last Name:MULLIN
Suffix:
Gender:F
Credentials:MSW LCSW CAP SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6446 FOSTER STREET
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-575-6119
Mailing Address - Fax:561-841-8885
Practice Address - Street 1:1408 N KILLIAN DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403
Practice Address - Country:US
Practice Address - Phone:561-841-8885
Practice Address - Fax:561-841-8885
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2550L101YA0400X
FLSW56871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical