Provider Demographics
NPI:1780770677
Name:MULLEN, NATASHA L (LPCMH)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:L
Last Name:MULLEN
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:MS
Other - First Name:NATASHA
Other - Middle Name:L
Other - Last Name:FRESHWATER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1213 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806
Mailing Address - Country:US
Mailing Address - Phone:302-652-3948
Mailing Address - Fax:302-652-8297
Practice Address - Street 1:1213 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806
Practice Address - Country:US
Practice Address - Phone:302-652-3948
Practice Address - Fax:302-652-8297
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health