Provider Demographics
NPI:1275006546
Name:LINDER, MONICA PHYLLIS (LCSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:PHYLLIS
Last Name:LINDER
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 1:26400 NW SAINT HELENS RD SLIP 36
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-9629
Mailing Address - Country:US
Mailing Address - Phone:503-781-6634
Mailing Address - Fax:
Practice Address - Street 1:1500 NW BETHANY BLVD STE 320
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5238
Practice Address - Country:US
Practice Address - Phone:503-567-3260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL79791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical