Healthcare Provider Details

I. General information

NPI: 1023148582
Provider Name (Legal Business Name): LINDA H. MCMULLEN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 WISCONSIN AVE NW SUITE 513
WASHINGTON DC
20015-2014
US

IV. Provider business mailing address

417 11TH ST SE
WASHINGTON DC
20003-2151
US

V. Phone/Fax

Practice location:
  • Phone: 202-543-3820
  • Fax: 202-364-0561
Mailing address:
  • Phone: 202-543-3829
  • Fax: 202-364-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC300907
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: