Provider Demographics
NPI:1982801213
Name:MULLINS, HUGO T (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HUGO
Middle Name:T
Last Name:MULLINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 CARPENTER DR NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4931
Mailing Address - Country:US
Mailing Address - Phone:678-460-0345
Mailing Address - Fax:678-460-0350
Practice Address - Street 1:270 CARPENTER DR NE
Practice Address - Street 2:SUITE 400
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4931
Practice Address - Country:US
Practice Address - Phone:678-460-0345
Practice Address - Fax:678-460-0350
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0012491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA182677041AMedicaid