Thomas John Mulligan, lcsw
Social Worker, Clinical in Fairfax, VA. Individual provider (NPI-1).
NPI number1861825317
StatusActive
Last updated in NPPESAug 19, 2013
Details
- NPI
- 1861825317
- Entity type
- Individual (NPI-1)
- Name
- Thomas John Mulligan
- Credential
- lcsw
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 19, 2013
- Last updated
- Aug 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 0904001079 | VA | Yes |
Practice location
3923 Old Lee HwyFairfax, VA 22030-2428
Phone 703-764-5298
Mailing address
3923 Old Lee HwyFairfax, VA 22030-2428
Phone 703-764-5298
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