Provider Demographics
NPI:1720355639
Name:MULLICAN, SHERI A (LPC)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:A
Last Name:MULLICAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 COUNTY ROAD 2041
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-0466
Mailing Address - Country:US
Mailing Address - Phone:936-554-8404
Mailing Address - Fax:
Practice Address - Street 1:1103 WILSON ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75652-6077
Practice Address - Country:US
Practice Address - Phone:903-655-0123
Practice Address - Fax:903-722-2624
Is Sole Proprietor?:No
Enumeration Date:2011-11-20
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16201101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health