Provider Demographics
NPI:1134301443
Name:LINKOUS, MARY COLEMAN
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:COLEMAN
Last Name:LINKOUS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:HELEN
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:490 CLAUDE HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:DEER LODGE
Mailing Address - State:TN
Mailing Address - Zip Code:37726-3439
Mailing Address - Country:US
Mailing Address - Phone:423-965-3720
Mailing Address - Fax:866-302-1319
Practice Address - Street 1:1420 NEAL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4333
Practice Address - Country:US
Practice Address - Phone:931-525-6900
Practice Address - Fax:931-525-6970
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health