Provider Demographics
NPI:1093739955
Name:AMES, LINDA LOU GERALDINE (LCSW, NCAC II, ACSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA LOU
Middle Name:GERALDINE
Last Name:AMES
Suffix:
Gender:F
Credentials:LCSW, NCAC II, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 E 64TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1671
Mailing Address - Country:US
Mailing Address - Phone:317-465-9833
Mailing Address - Fax:
Practice Address - Street 1:819 E 64TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1671
Practice Address - Country:US
Practice Address - Phone:317-465-9833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010399 CERTIFICATION101YA0400X
IN39000535A101YM0800X
IN34003706A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical