Healthcare Provider Details

I. General information

NPI: 1619010279
Provider Name (Legal Business Name): LINDA MCWHORTER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date: 07/10/2019
Reactivation Date: 07/19/2019

III. Provider practice location address

4700 LAS VEGAS BLVD N
NELLIS AFB NV
89191-6600
US

IV. Provider business mailing address

1207 DELAWARE AVE STE 2091
WILMINGTON DE
19806-4743
US

V. Phone/Fax

Practice location:
  • Phone: 702-653-2273
  • Fax:
Mailing address:
  • Phone: 704-493-4236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberB10011344
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS018664
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberB1-0011344
License Number StateDE
# 4
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberB10011344
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberB10011344
License Number StateDE
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPS018664
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPS018664
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberB1-0011344
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: