Provider Demographics
NPI:1972800035
Name:MULLEN, CHRISTINE MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:MULLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:MULLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:8 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-1126
Mailing Address - Country:US
Mailing Address - Phone:314-843-9385
Mailing Address - Fax:
Practice Address - Street 1:8 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1126
Practice Address - Country:US
Practice Address - Phone:314-843-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional