Provider Demographics
NPI:1255876926
Name:MULLINS, DELLA MARIE (LCPC)
Entity type:Individual
Prefix:MS
First Name:DELLA
Middle Name:MARIE
Last Name:MULLINS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 GRAND AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4982
Mailing Address - Country:US
Mailing Address - Phone:203-894-4889
Mailing Address - Fax:203-894-4888
Practice Address - Street 1:900 GRAND AVE APT 6
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4982
Practice Address - Country:US
Practice Address - Phone:203-894-4889
Practice Address - Fax:203-894-4888
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor