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Jamie Lynn Mullenhour

Counselor

Behavioral Health & Social Service Providers

2005 Valparaiso St, Suite 209, Valparaiso, IN 46383-3329

PECOS Enrollment

This provider is enrolled in PECOS as JAMIE MULLENHOUR.

Based on the most recent information from CMS, provider Jamie Lynn Mullenhour is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:05 AM.

Profile Details

Provider ID
1952847113
Provider Type
Individual
Full Name
Mullenhour, Jamie Lynn
Title
Mrs.
Credential
LMHC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/12/2017
Last Updated
1/12/2017

Contact Information

Practice Location

2005 Valparaiso St, Suite 209, Valparaiso, IN 46383-3329

(219) 252-5464

Unlisted Fax

Mailing Location

2005 Valparaiso St, Suite 209, Valparaiso, IN 46383-3329

(219) 252-5464

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 39002955A Indiana

Jamie Lynn Mullenhour

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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