Provider Demographics
NPI:1275935447
Name:ANTHONY & DENISE MULLENHOUR
Entity Type:Organization
Organization Name:ANTHONY & DENISE MULLENHOUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLENHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:317-441-2131
Mailing Address - Street 1:9256 ANDIRON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1486
Mailing Address - Country:US
Mailing Address - Phone:317-441-2131
Mailing Address - Fax:317-876-3600
Practice Address - Street 1:3307 W 96TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1106
Practice Address - Country:US
Practice Address - Phone:317-441-2131
Practice Address - Fax:317-876-3600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN24005898A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty