Provider Demographics
NPI:1861426967
Name:MCMULLEN, LINDA ROYSTER (LPC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROYSTER
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6278
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-0278
Mailing Address - Country:US
Mailing Address - Phone:252-523-2769
Mailing Address - Fax:252-523-9409
Practice Address - Street 1:3435 LAKEVIEW TRL
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-8182
Practice Address - Country:US
Practice Address - Phone:252-523-2769
Practice Address - Fax:252-523-9409
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1082101YP2500X
GALPC000329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional