MR. SHANE J MULLEN (NPI# 1174640742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174640742 |
| Entity Type | Individual |
| Full Name | MR. SHANE J MULLEN |
| Credential | LCP |
| Practice Address |
2950 Sw Woodside Dr Topeka KS 66614-5326 |
| Mailing Address |
2001 Meadowlark Ln Emporia KS 66801-6127 |
| Practice Telephone | 7852725134 |
| Practice Fax Number | 7852724370 |
| Mailing Telephone | 6203410865 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 052 | KS | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
052 | KS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200434290B | 05 |
| Street Address |
2950 SW WOODSIDE DR |
| City | TOPEKA |
| State | KS |
| Zip Code | 66614-5326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215044953 | Patricia Warner Henry | Social Worker | 2950 Sw Woodside Dr, Woodridge Counseling Services, Topeka, KS 66614-5326 | 2006-08-25 |
| 1851766653 | Shaun Ball | Social Worker | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2015-12-04 |
| 1811318504 | Pathways for Life, LLC | Clinic/Center | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2013-12-23 |
| 1134473176 | Linda M. Bishop | Counselor | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2012-10-29 |
| 1093086324 | Chelsy Larson | Social Worker | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2012-01-18 |
| 1508141250 | Roberta Louise Bridges | Social Worker | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2011-10-13 |
| 1205146297 | Counseling Solutions, LLC | Counselor | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2010-10-08 |
| 1720309727 | Spencer Mitchel Sward | Social Worker | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2010-06-14 |
| 1205069887 | Connie Lynn Roberts | Social Worker | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2009-08-28 |
| 1558500413 | Krista Ann Kite | Social Worker | 2950 Sw Woodside Dr, Topeka, KS 66614-5326 | 2009-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205356516 | James Michael Mcgill | Counselor | 2121 Sw Chelsea Dr., Topeka, KS 66614 | 2017-06-27 |
| 1366988339 | Tracy Sprague | Nurse Practitioner | 2655 Sw Wanamaker, Topeka, KS 66614 | 2017-01-13 |
| 1336518976 | Pearlie Mae's Compassion and Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2956 Sw Seabrook Ave, Topeka, KS 66614 | 2015-09-24 |
| 1124424924 | Sunflower Smiles Pediatric Dentistry | Dentist | 3635 Sw Fairlawn Road, Suite 1, Topeka, KS 66614 | 2014-11-06 |
| 1902200371 | Katie Lynn Schippers | Pharmacist | 55311 Sw 22nd Pl, Topeka, KS 66614 | 2014-10-14 |
| 1457767105 | Eugene Curtis | Dentist | 2221 Sw Auburn Rd, Topeka, KS 66614 | 2014-07-02 |
| 1538583190 | Arnold V. Mueller | Internal Medicine | 2737 S.w. Bluestem Dr., Topeka, KS 66614 | 2014-02-18 |
| 1477991610 | Robert Roy Payne | Orthopaedic Surgery | 2403 Southwest Brookhaven Lane, Robert R. Payne, M.d, Topeka, KS 66614 | 2013-06-10 |
| 1134425556 | Dale Lake | Case Manager/Care Coordinator | 2706 Sw Tutbury Town Rd, Topeka, KS 66614 | 2011-02-02 |
| 1013248558 | Aline Boutz | Assisted Living Facility | 7720 Sw Asbury Dr, Topeka, KS 66614 | 2010-01-22 |
| Find all providers in zip 66614 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437344694 | Janelle Marie Tidemann | Psychologist | 5847 Sw 29th St, Topeka, KS 66614-2462 | 2007-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174097133 | Janine Kesterson-cravens | Psychologist | 8100 E 22nd St N # 1600, Wichita, KS 67226-2388 | 2019-01-14 |
| 1073978979 | Kari Struemph | Psychologist | 2106 Olathe Blvd Mailstop 4004, Kansas City, KS 66160-0001 | 2015-12-18 |
| 1568655637 | Deidra Mcgie Johnson | Psychologist | 1102 S. Rouse, Pittsburg, KS 66762 | 2007-08-22 |
| 1225220858 | Leticia Ann Holub Taylor | Psychologist | 515 N Mur Len Rd, Olathe, KS 66062-1267 | 2007-08-17 |
| 1760674808 | Eric Morrison Vernberg | Psychologist | 1000 Sunnyside Ave, Clinical Child Psychology Program, Lawrence, KS 66045-7555 | 2007-08-13 |
| 1649476094 | Stephen Robert Lassen | Psychologist | 3901 Rainbow Blvd # Ms -4004, Kansas City, KS 66160-0001 | 2007-06-22 |
| 1710033642 | Charles Anthony Krall | Psychologist | 426 W 14th St, Chanute, KS 66720-2878 | 2007-01-25 |
| 1952453573 | Nathan A Fawson | Psychologist | 304 N Jefferson, Iola, KS 66749 | 2007-01-16 |
| 1902465701 | Alison Kathleen Calkins-smith | Psychologist | 8800 W 75th St Ste 220, Shawnee Mission, KS 66204-4001 | 2019-06-06 |
| 1902306640 | Amy E Noser | Psychologist | 200 Maine St Ste A, Lawrence, KS 66044-1396 | 2018-02-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.