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General NPI Number Information
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NPI Number | 1407194046
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Entity Type | Individual
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Provider Name | DOUGLAS JOE MULLER PH.D., LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 606 DENBIGH BLVD STE 100
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-4413
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Country | US
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Telephone | 757-864-0675
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Fax | 757-282-7744
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Provider Business Mailing Address
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Address Line | 606 DENBIGH BLVD STE 100
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-4413
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Country | US
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Telephone | 757-864-0673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710000942
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701002362
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717000443
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904004628
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License Number State | VA
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