Jeremy Randall Mullis, MA is a
Psychologist based in Wilmington, North Carolina. Jeremy Randall Mullis is licensed to practice in North Carolina (license number 4647) and his current practice location is
4701 Wrightsville Avenue Bldg 1 Unit D-4, Wilmington, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(910) 899-4060.
NPI number for Jeremy Randall Mullis is 1922240928 and his current mailing address is 4701 Wrightsville Avenue Bldg 1 Unit D-4, Wilmington, North Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1922240928.
Healthcare Provider's Profile
| Full Name | Jeremy Randall Mullis |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 4701 Wrightsville Avenue Bldg 1 Unit D-4, Wilmington, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1922240928
- Provider Enumeration Date: 04/06/2009
- Last Update Date: 04/13/2022
Medical Identifiers
Medical identifiers for Jeremy Randall Mullis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922240928 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 4647 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeremy Randall Mullis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jeremy Randall Mullis, MA
4701 Wrightsville Avenue Bldg 1 Unit D-4,
Wilmington, NC 28403-6911
Ph: (910) 899-4060 | Jeremy Randall Mullis, MA
4701 Wrightsville Avenue Bldg 1 Unit D-4,
Wilmington, NC 28403-2840
Ph: (910) 899-4060 |
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