Healthcare Provider Details

I. General information

NPI: 1306299094
Provider Name (Legal Business Name): JEFFREY LEE MUELLER LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E GUDE DR
ROCKVILLE MD
20850-5307
US

IV. Provider business mailing address

1500 E GUDE DR
ROCKVILLE MD
20850-5307
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-1720
  • Fax: 240-777-3381
Mailing address:
  • Phone: 240-777-1720
  • Fax: 240-777-4169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20354
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20354
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: