Provider Demographics
NPI:1336975010
Name:MULLEN, AUDEN (LSW)
Entity type:Individual
Prefix:
First Name:AUDEN
Middle Name:
Last Name:MULLEN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11847 E KEPNER DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3284
Mailing Address - Country:US
Mailing Address - Phone:937-776-8442
Mailing Address - Fax:
Practice Address - Street 1:11847 E KEPNER DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3284
Practice Address - Country:US
Practice Address - Phone:937-776-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009925427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health