Provider Demographics
NPI:1619010279
Name:MCWHORTER, LINDA (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ODYSSEY ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5253
Mailing Address - Country:US
Mailing Address - Phone:704-493-4236
Mailing Address - Fax:
Practice Address - Street 1:1207 DELAWARE AVE STE 2091
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4743
Practice Address - Country:US
Practice Address - Phone:704-493-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2025-06-09
Deactivation Date:2019-07-10
Deactivation Code:
Reactivation Date:2019-07-19
Provider Licenses
StateLicense IDTaxonomies
DEB1-0011344103T00000X, 103TC0700X, 103TH0100X
PAPS018664103TC2200X, 103TF0000X, 103TH0004X
DEB10011344103TC2200X, 103TH0004X, 103TF0000X, 103TH0004X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250718792Medicaid
PAPS018664OtherPENNSYLVANIA PSYCHOLOGY LICENSE
DE250718794Medicaid
DE5332079OtherHIGHMARK HEALTH OPTIONS PROVIDER ID
DEB1-0011344OtherDELAWARE PSYCHOLOGY LICENSE
DE250718791Medicaid
DE250718793Medicaid
DE2023712026OtherDE BUSINESS LICENSE