Provider Demographics
NPI:1023148582
Name:MCMULLEN, LINDA H (MSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:H
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 11TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2151
Mailing Address - Country:US
Mailing Address - Phone:202-543-3829
Mailing Address - Fax:202-364-0561
Practice Address - Street 1:5225 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 513
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2014
Practice Address - Country:US
Practice Address - Phone:202-543-3820
Practice Address - Fax:202-364-0561
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3009071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC652752Medicare ID - Type Unspecified