Provider Demographics
NPI:1225020209
Name:TOWRY, LINDA RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:RAE
Last Name:TOWRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 1/2 VINEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-3140
Mailing Address - Country:US
Mailing Address - Phone:478-960-3257
Mailing Address - Fax:
Practice Address - Street 1:78TH MDOS/SGOHF
Practice Address - Street 2:655 7TH ST. BLDG 799
Practice Address - City:ROBINS AIR FORCE BASE
Practice Address - State:GA
Practice Address - Zip Code:31098
Practice Address - Country:US
Practice Address - Phone:478-222-4801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA25621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical