Provider Demographics
NPI:1205847381
Name:WARE, LINDA SUZANNE (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUZANNE
Last Name:WARE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 E WHALERS WAY
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2148
Mailing Address - Country:US
Mailing Address - Phone:480-775-7637
Mailing Address - Fax:480-820-6254
Practice Address - Street 1:1845 S DOBSON RD
Practice Address - Street 2:STE # 204
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5661
Practice Address - Country:US
Practice Address - Phone:480-775-7637
Practice Address - Fax:480-820-6254
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional