Provider Demographics
NPI:1760955470
Name:MULVANY, SUSAN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:MULVANY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 DUPONT CIR
Mailing Address - Street 2:
Mailing Address - City:HOWEY IN THE HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34737-3106
Mailing Address - Country:US
Mailing Address - Phone:352-360-5746
Mailing Address - Fax:
Practice Address - Street 1:1230 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1961
Practice Address - Country:US
Practice Address - Phone:352-708-6283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIM16590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health