BRIAN MULLERVY NPI 1467875633

NPI Information

NPI: 1467875633
Provider Name: BRIAN MULLERVY
Classification: Counselor - 101Y00000X
Entity Type: Individual
Organization: GATEWAY HEALTHCARE INC

PECOS Registration: Yes

Address:
101 BACON ST
PAWTUCKET, RI
ZIP 02860
Phone: (401) 724-8400
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Brian Mullervy is a counselor in Pawtucket, RI with 11 years of experience. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Brian Mullervy NPI is 1467875633. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 BACON ST
PAWTUCKET, RI
ZIP 02860-542
Phone: (401) 724-8400
Fax: (401) 722-5280

The NPI 1467875633 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 1/24/2014 and was last updated on 1/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1041C0700X	Social Worker	Clinical	CSW02074	RHODE ISLAND	No
2	101Y00000X	Counselor				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GH57134	MEDICAID	RHODE ISLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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