Provider Demographics
NPI:1073685921
Name:REICHERT, LINDA LENORE (LCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LENORE
Last Name:REICHERT
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:LENORE
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2716 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-7730
Mailing Address - Country:US
Mailing Address - Phone:254-288-6474
Mailing Address - Fax:
Practice Address - Street 1:761ST TANK BN RD
Practice Address - Street 2:
Practice Address - City:FT. HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-6474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVAD000Medicare UPIN