Provider Demographics
NPI:1952472532
Name:MULCAHY, EILEEN MARIE (CLIN SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARIE
Last Name:MULCAHY
Suffix:
Gender:F
Credentials:CLIN SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BELLVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3142
Mailing Address - Country:US
Mailing Address - Phone:504-542-0200
Mailing Address - Fax:540-542-0218
Practice Address - Street 1:120 BELLVIEW AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3142
Practice Address - Country:US
Practice Address - Phone:504-542-0200
Practice Address - Fax:540-542-0218
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040039041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904003904Medicaid