1801906151 NPI number — DR. ROBIN LYNN MCMAHON LCSW, PHD

Table of content: MS. JODI L HYNDMAN APRN (NPI 1225050255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801906151 NPI number — DR. ROBIN LYNN MCMAHON LCSW, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMAHON
Provider First Name:
ROBIN
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, 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:
1801906151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5909 22ND ST N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22205-3326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-533-0132
Provider Business Mailing Address Fax Number:
703-533-0139

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5909 22ND ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22205-3326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-533-0132
Provider Business Practice Location Address Fax Number:
703-533-0139
Provider Enumeration Date:
08/30/2006

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: 1041C0700X , with the licence number:  0904002333 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10848 . This is a "CLIN SW LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0904002333 . This is a "CLIN. SOC. WORK LICENSE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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