Provider Demographics
NPI:1184858557
Name:MILDWURF, LINDA ROBINSON (MSW, P-LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ROBINSON
Last Name:MILDWURF
Suffix:
Gender:F
Credentials:MSW, P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W MILLBROOK RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4389
Mailing Address - Country:US
Mailing Address - Phone:919-845-9977
Mailing Address - Fax:
Practice Address - Street 1:312 W MILLBROOK RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4389
Practice Address - Country:US
Practice Address - Phone:919-845-9977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0049411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical