Provider Demographics
NPI:1003246422
Name:LINTON, MCKENZIE DANIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:DANIELLE
Last Name:LINTON
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 1:353 WESTERN DR
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-2087
Mailing Address - Country:US
Mailing Address - Phone:614-620-7773
Mailing Address - Fax:
Practice Address - Street 1:970 BLOOMFIELD RD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9708
Practice Address - Country:US
Practice Address - Phone:502-509-6717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical