Provider Demographics
NPI:1760367858
Name:MULLENIX, ANDREW (LPC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MULLENIX
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1065
Mailing Address - Country:US
Mailing Address - Phone:330-620-9651
Mailing Address - Fax:
Practice Address - Street 1:273 MAIN ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1489
Practice Address - Country:US
Practice Address - Phone:330-331-9203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2507252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health