Provider Demographics
NPI:1073519872
Name:MARTIN, LINDA A (LCSW,RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LCSW,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 MURRAY AVE
Mailing Address - Street 2:STE 305
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1655
Mailing Address - Country:US
Mailing Address - Phone:412-521-2126
Mailing Address - Fax:412-521-3995
Practice Address - Street 1:1824 MURRAY AVE
Practice Address - Street 2:STE 305
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1655
Practice Address - Country:US
Practice Address - Phone:412-521-2126
Practice Address - Fax:412-521-3995
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0128801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA762560OtherHIGHMARK
PAPO38125OtherTRICARE
PA80-01786760Medicaid
PA0017867600001Medicaid
PA74795OtherUNITED BEHAVIORAL HEALTH
PA74795OtherUNITED BEHAVIORAL HEALTH
PAS34740Medicare UPIN