Provider Demographics
NPI:1043245947
Name:CHALOU, LINDA M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:CHALOU
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 1:355 MAHANY RD
Mailing Address - Street 2:P O BOX 404
Mailing Address - City:EASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04740-4345
Mailing Address - Country:US
Mailing Address - Phone:207-488-6934
Mailing Address - Fax:
Practice Address - Street 1:147 ACADEMY STREET
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769
Practice Address - Country:US
Practice Address - Phone:207-764-6825
Practice Address - Fax:207-764-6077
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC62601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical