Provider Demographics
NPI:1679372965
Name:MCMULLEN, CATHERINE (LLMSW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:MCMULLEN
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 N IRISH RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8949
Mailing Address - Country:US
Mailing Address - Phone:810-955-5214
Mailing Address - Fax:
Practice Address - Street 1:126 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-8623
Practice Address - Country:US
Practice Address - Phone:810-458-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23237040801101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health