Provider Demographics
NPI:1407647951
Name:MULKINS, COURTNEY ELIZABETH
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:MULKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 E COOKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-5650
Mailing Address - Country:US
Mailing Address - Phone:845-407-1996
Mailing Address - Fax:
Practice Address - Street 1:6423 STATE RTE 55
Practice Address - Street 2:
Practice Address - City:WINGDALE
Practice Address - State:NY
Practice Address - Zip Code:12580
Practice Address - Country:US
Practice Address - Phone:845-832-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health