Provider Demographics
NPI:1740985035
Name:KELLI MULLEN LLC
Entity type:Organization
Organization Name:KELLI MULLEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-416-4317
Mailing Address - Street 1:PO BOX 1214
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59103-1214
Mailing Address - Country:US
Mailing Address - Phone:406-416-4317
Mailing Address - Fax:406-797-1605
Practice Address - Street 1:2812 1ST AVE N STE 511
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-2312
Practice Address - Country:US
Practice Address - Phone:406-416-4317
Practice Address - Fax:406-797-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty