Provider Demographics
NPI:1144617523
Name:MULLEN, HOLLY ANN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:MULLEN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:DELGROSSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-0688
Mailing Address - Fax:484-884-0628
Practice Address - Street 1:1240 S CEDAR CREST BLVD STE 410
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6218
Practice Address - Country:US
Practice Address - Phone:610-402-7884
Practice Address - Fax:610-402-8876
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130601101Y00000X
PACW0191201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor