Provider Demographics
NPI:1710221593
Name:MULLENIX, EUGENIA (LMFT)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:MULLENIX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EUGENIA
Other - Middle Name:
Other - Last Name:MULLENIX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:1574 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-8220
Mailing Address - Country:US
Mailing Address - Phone:203-308-6429
Mailing Address - Fax:
Practice Address - Street 1:1574 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-8220
Practice Address - Country:US
Practice Address - Phone:203-308-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-15-19991103K00000X
CT001337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst