Individual
MARK NOLAND MUELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
VA SALT LAKE CITY HEALTH CARE SYSTEM MENTAL, 500 FOOTHILL DR., SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
VA SALT LAKE CITY HEALTH CARE SYS. MENTAL HEALTH ER, 500 FOOTHILL DR., SALT LAKE CITY, UT 84148
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
99-3357453501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003103005
RAILROAD MEDICARE
UT
01
—
107035233101
INTERMOUNTAIN HEALTH CARE
UT
01
—
33574535001001
BLUE CROSS
UT
01
—
633730
DESERET MUTUAL
UT
01
—
9429383484121A250
CHAMPUS
UT
01
—
942938348MEU
EDUCATORS MUTUAL
UT
01
—
P26861
MEDICARE ADVANTAGE PLUS
UT
Enumeration date
12/15/2005
Last updated
03/05/2014
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