Provider Demographics
NPI:1801760020
Name:BARKER MULLINS, ANGELINA (CDCA)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:BARKER MULLINS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 MOUNT JOY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-2623
Mailing Address - Country:US
Mailing Address - Phone:937-408-3165
Mailing Address - Fax:
Practice Address - Street 1:1948 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2648
Practice Address - Country:US
Practice Address - Phone:866-534-2639
Practice Address - Fax:800-480-7578
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.192990101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty