Provider Demographics
NPI:1184852337
Name:MULLIS, DEBBIE JONES (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:JONES
Last Name:MULLIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HIGHLAND LAKES DR
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-7282
Mailing Address - Country:US
Mailing Address - Phone:478-374-2496
Mailing Address - Fax:
Practice Address - Street 1:500 HIGHLAND LAKES DR
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-7282
Practice Address - Country:US
Practice Address - Phone:478-374-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0039301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical