Provider Demographics
NPI:1093853954
Name:CONOVER, LINDA M (LPCC, CCDC I)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:CONOVER
Suffix:
Gender:F
Credentials:LPCC, CCDC I
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC, CCDC I
Mailing Address - Street 1:90 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2301
Mailing Address - Country:US
Mailing Address - Phone:740-593-3682
Mailing Address - Fax:740-594-5642
Practice Address - Street 1:90 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2301
Practice Address - Country:US
Practice Address - Phone:740-593-3682
Practice Address - Fax:740-594-5642
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011115101YA0400X
OHE.0003088-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)