Provider Demographics
NPI:1194086876
Name:MULLINS, CARLA ELIOT (LMHC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ELIOT
Last Name:MULLINS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:GAYE
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 801
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-0801
Mailing Address - Country:US
Mailing Address - Phone:360-812-0251
Mailing Address - Fax:
Practice Address - Street 1:2120 RIVERSTONE LOOP
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-8024
Practice Address - Country:US
Practice Address - Phone:360-739-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60346804101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health