Provider Demographics
NPI:1336313212
Name:MULLINAX, STACI LENAE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACI
Middle Name:LENAE
Last Name:MULLINAX
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 1:11777 KATY FWY STE 350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1721
Mailing Address - Country:US
Mailing Address - Phone:713-365-0700
Mailing Address - Fax:713-827-1080
Practice Address - Street 1:11777 KATY FWY STE 350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079
Practice Address - Country:US
Practice Address - Phone:713-365-0700
Practice Address - Fax:713-827-1080
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical