Provider Demographics
NPI:1235310392
Name:BRECK, LINDA YVONNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:YVONNE
Last Name:BRECK
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:USAHC BAUMHOLDER ATTN SOCIAL WORK SERVICES
Mailing Address - Street 2:UNIT 23809 BOX 52
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09034-3809
Mailing Address - Country:US
Mailing Address - Phone:49067-836-7411
Mailing Address - Fax:49067-836-6721
Practice Address - Street 1:USAHC BAUMHOLDER ATTN SOCIAL WORK SERVICES
Practice Address - Street 2:UNIT 23809 BOX 52
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09034-3809
Practice Address - Country:US
Practice Address - Phone:49067-836-7411
Practice Address - Fax:49067-836-6721
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW2634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health