Provider Demographics
NPI:1194814368
Name:WOEHLKE, LINDA MARIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:WOEHLKE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-0826
Mailing Address - Country:US
Mailing Address - Phone:301-862-4966
Mailing Address - Fax:301-862-5554
Practice Address - Street 1:SMALLWOOD BUILDING
Practice Address - Street 2:2670 CRAIN HIGHWAY, SUITE 525
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-632-2100
Practice Address - Fax:301-632-2150
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical