Provider Demographics
NPI:1235204728
Name:WEINBAUM, LINDA ELAINE (LCSW, BCD, ACSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ELAINE
Last Name:WEINBAUM
Suffix:
Gender:F
Credentials:LCSW, BCD, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 SE 1ST AVE
Mailing Address - Street 2:BUILDING 100
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0477
Mailing Address - Country:US
Mailing Address - Phone:843-610-0061
Mailing Address - Fax:352-732-0455
Practice Address - Street 1:3002 SE 1ST AVE
Practice Address - Street 2:BUILDING 100
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0477
Practice Address - Country:US
Practice Address - Phone:843-610-0061
Practice Address - Fax:352-732-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC69511041C0700X
FLSW95901041C0700X
IN34000188A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQMO731Medicaid
SCQ330530281Medicare ID - Type Unspecified
SCQMO731Medicaid
FLEZ754AMedicare PIN