1144605197 NPI number — PROFESSIONAL SERVICES OF SHERRY MULLINS, LLC

Table of content: (NPI 1598027427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144605197 NPI number — PROFESSIONAL SERVICES OF SHERRY MULLINS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL SERVICES OF SHERRY MULLINS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144605197
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1624 MARK HOPKINS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLOOMFIELD HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48302-2647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-430-4224
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23023 ORCHARD LAKE RD
Provider Second Line Business Practice Location Address:
G1
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48336-3209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-430-4224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MULLINS
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
Authorized Official Title or Position:
LICENSED PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
248-430-4224

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  6401005021 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com