Provider Demographics
NPI:1033326384
Name:TODD, LINDA JEAN (MSSW, ACSW,)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JEAN
Last Name:TODD
Suffix:
Gender:F
Credentials:MSSW, ACSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-0284
Mailing Address - Country:US
Mailing Address - Phone:505-758-3533
Mailing Address - Fax:
Practice Address - Street 1:114 LAS CRUCES RD.
Practice Address - Street 2:UNIT E
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-0284
Practice Address - Country:US
Practice Address - Phone:505-758-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-00161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical