Provider Demographics
NPI:1609955657
Name:MULICK, PATRICK SEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:SEAN
Last Name:MULICK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7417
Mailing Address - Country:US
Mailing Address - Phone:870-698-2100
Mailing Address - Fax:870-698-0109
Practice Address - Street 1:2397 HARRISON ST
Practice Address - Street 2:SUITE C
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7420
Practice Address - Country:US
Practice Address - Phone:870-262-1357
Practice Address - Fax:870-698-0109
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 3413103TC0700X
AR0806P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical