Provider Demographics
NPI:1710010004
Name:MULLIKEN, TODD K (LPC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:K
Last Name:MULLIKEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 EDINA INDUSTRIAL BLVD
Mailing Address - Street 2:#124
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2918
Mailing Address - Country:US
Mailing Address - Phone:952-835-7130
Mailing Address - Fax:952-831-1783
Practice Address - Street 1:5275 EDINA INDUSTRIAL BLVD
Practice Address - Street 2:#124
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2918
Practice Address - Country:US
Practice Address - Phone:952-835-7130
Practice Address - Fax:952-831-1783
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00335101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00335OtherLPC