1619010279 NPI number — DR. LINDA MCWHORTER PHD

Table of content: MICHAEL DAVID HOFMANN M.D. (NPI 1003841271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619010279 NPI number — DR. LINDA MCWHORTER PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCWHORTER
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619010279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/10/2019
NPI Reactivation Date:
07/19/2019

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
209 ODYSSEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89074-5253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-493-4236
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1207 DELAWARE AVE STE 2091
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19806-4743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-493-4236
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  B1-0011344 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: B1-0011344 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X , with the licence number: PS018664 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC2200X , with the licence number: B10011344 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0000X , with the licence number: PS018664 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TH0004X , with the licence number: PS018664 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TH0004X , with the licence number: B10011344 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0000X , with the licence number: B10011344 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 250718792 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: PS018664 . This is a "PENNSYLVANIA PSYCHOLOGY LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 250718794 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5332079 . This is a "HIGHMARK HEALTH OPTIONS PROVIDER ID" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: B1-0011344 . This is a "DELAWARE PSYCHOLOGY LICENSE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 250718791 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 250718793 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2023712026 . This is a "DE BUSINESS LICENSE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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