Provider Demographics
NPI:1235169020
Name:BRISBIN, LINDA J (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:BRISBIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-2255
Mailing Address - Country:US
Mailing Address - Phone:704-636-1155
Mailing Address - Fax:
Practice Address - Street 1:100 W INNES ST
Practice Address - Street 2:SUITE 303
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4344
Practice Address - Country:US
Practice Address - Phone:704-633-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0020541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18488OtherBLUE CROSS BLUE SHIELD