Provider Demographics
NPI:1003111329
Name:TANDET, LINDA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:TANDET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 IL ROUTE 83
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047-9563
Mailing Address - Country:US
Mailing Address - Phone:847-707-1231
Mailing Address - Fax:
Practice Address - Street 1:4180 IL ROUTE 83
Practice Address - Street 2:SUITE 10
Practice Address - City:LONG GROVE
Practice Address - State:IL
Practice Address - Zip Code:60047-9563
Practice Address - Country:US
Practice Address - Phone:847-707-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.002888101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional