Provider Demographics
NPI:1083310585
Name:BARTH, LINDA R (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:BARTH
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 1:909 E. WILLOW GROVE AVE
Mailing Address - Street 2:#204
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038
Mailing Address - Country:US
Mailing Address - Phone:215-242-3915
Mailing Address - Fax:
Practice Address - Street 1:909 E. WILLOW GROVE AVE
Practice Address - Street 2:#204
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038
Practice Address - Country:US
Practice Address - Phone:215-242-3915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0141971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical