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NPI Code Detail

MEDICARE: DR. LINDA GERARDINE MCCULLOUGH PH.D., LPC

MEDICARE: DR. LINDA GERARDINE MCCULLOUGH PH.D., LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPRC1334DC
2101YP2500XProfessional Counselor0701002605VA

General Provider Information

NPI Number : 1124102488
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA GERARDINE MCCULLOUGH PH.D., LPC
Provider Business Mailing Address
First Line : 722 RICHMOND AVE
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-5224
Country : US
Telephone Number : 301-565-2434
Fax Number :
Provider Business Practice Location Address
First Line : 1221 TAYLOR ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-5617
Country : US
Telephone Number : 202-464-9200
Fax Number : 202-464-5730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 07/08/2007

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