MS. BLAKELY ELIZABETH MULDER MA, AGS
NPI 1629698683
Psychologist - School in Durham, NC

Active since April 20, 2020Opted out of Medicare · through Nov 3, 2027
5842 FAYETTEVILLE RD STE 106, DURHAM, NC 27713(919) 572-0000 Get Directions Write a Review

NPPES record last updated: April 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Blakely Elizabeth Mulder Ma, Ags NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. BLAKELY ELIZABETH MULDER MA, AGS (NPI 1629698683) is an individual school provider in Durham, North Carolina, licensed in North Carolina (1236076) and active in the NPI registry since April 2020. She has opted out of Medicare through November 3, 2027.

NPPES Registry Identity

NPI1629698683
Entity TypeIndividualFemale
Primary Taxonomy103TS0200X
Provider Legal NameMS. BLAKELY ELIZABETH MULDERCredential: MA, AGS
Location Address5842 FAYETTEVILLE RD STE 106Durham, NC 27713-6294
Mailing Address5842 Fayetteville Rd Ste 106Durham, NC 27713-6294 · (919) 572-0000
Sole ProprietorNo
Enumeration DateApril 20, 2020
NPPES CertifiedApril 20, 2020
NPI 1629698683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · SchoolBehavioral Health & Social Service Providers
Taxonomy Code103TS0200X
License Licensed in NC · 1236076
Definition
A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development
5842 FAYETTEVILLE RD STE 106, Durham, NC 27713

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Blakely Elizabeth Mulder Ma, Ags has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 3, 2021 through November 3, 2027.

Opt-Out Effective DateNovember 3, 2021
Opt-Out In Effect ThroughNovember 3, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Psychologist (Clinical)
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Psychiatry & Neurology (Psychiatry)
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Psychologist
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Psychologist
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Psychologist (Clinical)
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Counselor (Mental Health)
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713
Psychologist
5842 FAYETTEVILLE RD STE 106
DURHAM, NC 27713

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blakely Mulder's NPI number?

The NPI number for Blakely Mulder is 1629698683. It was assigned to this individual provider in the NPPES registry on April 20, 2020.

Where is Blakely Mulder located?

Blakely Mulder practices at 5842 Fayetteville Rd Ste 106, Durham, NC 27713. The listed phone number is (919) 572-0000.

What is Blakely Mulder's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in School, with taxonomy code 103TS0200X.

Is Blakely Mulder enrolled in Medicare?

No. Blakely Mulder has opted out of Medicare through November 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Blakely Mulder was last updated on April 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.