Provider Demographics
NPI:1235177155
Name:MULLENIOUX, CAROL N (ATR-BC, LCPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:N
Last Name:MULLENIOUX
Suffix:
Gender:F
Credentials:ATR-BC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 W SAGE CIR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5059
Mailing Address - Country:US
Mailing Address - Phone:913-302-1303
Mailing Address - Fax:
Practice Address - Street 1:13839 S MUR LEN RD
Practice Address - Street 2:SUITE K
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1652
Practice Address - Country:US
Practice Address - Phone:913-764-5463
Practice Address - Fax:913-764-4160
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS043101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional