MEDICARE: JANINE ANNETTE MULLER LCSW

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
1	1041C0700X	Clinical Social Worker	C005001	NC

General Provider Information

NPI Number	:	1609875681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANINE ANNETTE MULLER LCSW

Provider Business Mailing Address
First Line	:	1905 J N PEASE PL
Second Line	:	#201
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4557
Country	:	US
Telephone Number	:	704-561-1411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 J N PEASE PL
Second Line	:	#201
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4557
Country	:	US
Telephone Number	:	704-561-1411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	06/24/2013

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