Provider Demographics
NPI:1326589995
Name:MULLINS, KEVIN (LPC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:MULLINS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 INTERSTATE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-1526
Mailing Address - Country:US
Mailing Address - Phone:334-332-4447
Mailing Address - Fax:
Practice Address - Street 1:890 N DEAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-9440
Practice Address - Country:US
Practice Address - Phone:334-332-4447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional