Provider Demographics
NPI:1619542107
Name:MULLEN, ROBERT P (LPC-S)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:MULLEN
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7709 PERKINS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-7411
Mailing Address - Country:US
Mailing Address - Phone:817-894-7455
Mailing Address - Fax:
Practice Address - Street 1:6300 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2631
Practice Address - Country:US
Practice Address - Phone:972-257-0449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15470101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional