Provider Demographics
NPI:1922617760
Name:MULLINIX, PAMELA JOY (LCPC-CC, RNC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:JOY
Last Name:MULLINIX
Suffix:
Gender:F
Credentials:LCPC-CC, RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:ME
Mailing Address - Zip Code:04055-3628
Mailing Address - Country:US
Mailing Address - Phone:207-329-6319
Mailing Address - Fax:
Practice Address - Street 1:8 SPRUCE LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:ME
Practice Address - Zip Code:04055-3628
Practice Address - Country:US
Practice Address - Phone:207-329-6319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN35123163WP0809X
MEXL5512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty