Provider Demographics
NPI:1396564639
Name:MULLEN, EMILY SHIREY (ALC)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:SHIREY
Last Name:MULLEN
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:SHIREY
Other - Last Name:BARFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ALC
Mailing Address - Street 1:2101 OWEN DR NE
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-7678
Mailing Address - Country:US
Mailing Address - Phone:256-630-5050
Mailing Address - Fax:
Practice Address - Street 1:2101 OWEN DR NE
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-7678
Practice Address - Country:US
Practice Address - Phone:256-630-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05046101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health