Provider Demographics
NPI:1164157442
Name:MULLINGS, EVELYN (MSW)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:MULLINGS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11843 NW 2ND MNR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8013
Mailing Address - Country:US
Mailing Address - Phone:954-589-3335
Mailing Address - Fax:
Practice Address - Street 1:213 S DILLARD ST STE 120B
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3596
Practice Address - Country:US
Practice Address - Phone:407-734-3338
Practice Address - Fax:407-734-3338
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLISW108751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health