Provider Demographics
NPI:1174856769
Name:HOWLEY-SKUBY, LINDA M (MSW, LCSW, CA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:HOWLEY-SKUBY
Suffix:
Gender:F
Credentials:MSW, LCSW, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 E EMPIRE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3252
Mailing Address - Country:US
Mailing Address - Phone:309-530-8555
Mailing Address - Fax:
Practice Address - Street 1:207 WEST JEFFERSON STREET
Practice Address - Street 2:#501
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701
Practice Address - Country:US
Practice Address - Phone:309-828-1988
Practice Address - Fax:309-828-6540
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1418101YA0400X
IL1362616101YS0200X
IL149.002048104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool