Provider Demographics
NPI:1407194046
Name:MULLER, DOUGLAS JOE (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:JOE
Last Name:MULLER
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 DENBIGH BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-4413
Mailing Address - Country:US
Mailing Address - Phone:757-864-0673
Mailing Address - Fax:
Practice Address - Street 1:606 DENBIGH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4413
Practice Address - Country:US
Practice Address - Phone:757-864-0675
Practice Address - Fax:757-282-7744
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YA0400X
VA0710000942101YA0400X
VA0701002362101YP2500X
VA0717000443106H00000X
VA09040046281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist