Provider Demographics
NPI:1619736451
Name:TIM MULLINS LPC LLC
Entity Type:Organization
Organization Name:TIM MULLINS LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:928-300-0071
Mailing Address - Street 1:4485 N EAGLE CIR
Mailing Address - Street 2:
Mailing Address - City:RIMROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86335-5136
Mailing Address - Country:US
Mailing Address - Phone:928-300-0071
Mailing Address - Fax:
Practice Address - Street 1:20 BELL ROCK PLZ STE G
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86351-9043
Practice Address - Country:US
Practice Address - Phone:928-300-0071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health