Provider Demographics
NPI:1033158738
Name:WARE, LINDA D (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:WARE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1953
Mailing Address - Country:US
Mailing Address - Phone:978-692-9498
Mailing Address - Fax:
Practice Address - Street 1:175 LITTLETON RD STE 10
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3120
Practice Address - Country:US
Practice Address - Phone:978-807-1164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2107851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP23532Medicare ID - Type UnspecifiedMEDICARE BILLING ID