Provider Demographics
NPI:1235559345
Name:MECKEL, LINDA SOUDERS (MSW, LBS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SOUDERS
Last Name:MECKEL
Suffix:
Gender:F
Credentials:MSW, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 GRAPE VINE DR
Mailing Address - Street 2:
Mailing Address - City:NEW TRIPOLI
Mailing Address - State:PA
Mailing Address - Zip Code:18066-3727
Mailing Address - Country:US
Mailing Address - Phone:610-657-9352
Mailing Address - Fax:610-298-8004
Practice Address - Street 1:7700 GRAPE VINE DR
Practice Address - Street 2:
Practice Address - City:NEW TRIPOLI
Practice Address - State:PA
Practice Address - Zip Code:18066-3727
Practice Address - Country:US
Practice Address - Phone:610-657-9352
Practice Address - Fax:610-298-8004
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000367103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst