Provider Demographics
NPI:1235466418
Name:SHADOIN-GRIER, LINDA MARIE
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:SHADOIN-GRIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:SHADOIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13336 INDUSTRIAL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1124
Mailing Address - Country:US
Mailing Address - Phone:402-895-4000
Mailing Address - Fax:402-895-1607
Practice Address - Street 1:2010 N 88TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6102
Practice Address - Country:US
Practice Address - Phone:402-496-1000
Practice Address - Fax:402-496-4209
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1623101YM0800X
IA010601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical