Provider Demographics
NPI:1811020258
Name:MULLIKEN COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:MULLIKEN COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:K
Authorized Official - Last Name:MULLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-835-7130
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty