Provider Demographics
NPI:1518619006
Name:MULLOY, CHARLOTTE (LPC)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:MULLOY
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 1:1781 SOUTHARD ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7500
Mailing Address - Country:US
Mailing Address - Phone:720-526-3556
Mailing Address - Fax:
Practice Address - Street 1:1781 SOUTHARD ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7500
Practice Address - Country:US
Practice Address - Phone:704-649-2317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017781101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health