Provider Demographics
NPI:1073512349
Name:LINDA E LOVE LCSW PC
Entity Type:Organization
Organization Name:LINDA E LOVE LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-270-6807
Mailing Address - Street 1:4966 RAIL DR
Mailing Address - Street 2:
Mailing Address - City:SANDSTON
Mailing Address - State:VA
Mailing Address - Zip Code:23150-5464
Mailing Address - Country:US
Mailing Address - Phone:804-221-6682
Mailing Address - Fax:
Practice Address - Street 1:5821 STAPLES MILL RD STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-5427
Practice Address - Country:US
Practice Address - Phone:804-221-6682
Practice Address - Fax:807-264-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040036391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010117461Medicaid