Provider Demographics
NPI:1205402336
Name:MULL, KAREN D (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:MULL
Suffix:
Gender:F
Credentials:LPC
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 87104
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85080-7104
Mailing Address - Country:US
Mailing Address - Phone:602-264-4600
Mailing Address - Fax:
Practice Address - Street 1:2828 N CENTRAL AVE # 801
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1021
Practice Address - Country:US
Practice Address - Phone:602-264-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-30
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional