Provider Demographics
NPI:1235267022
Name:SUMMERS, LINDA K (LPC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:K
Last Name:SUMMERS
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 1:8205 SPAIN RD NE STE 106
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3155
Mailing Address - Country:US
Mailing Address - Phone:505-306-2307
Mailing Address - Fax:505-260-9934
Practice Address - Street 1:9301 INDIAN SCHOOL RD NE STE 200E
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2861
Practice Address - Country:US
Practice Address - Phone:505-306-2307
Practice Address - Fax:505-260-9934
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0087141101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM251S00000X CBHOtherAGENCY