Provider Demographics
NPI:1285652875
Name:SAUCEDO, LINDA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ELIZABETH
Last Name:SAUCEDO
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 1:2217 RAVENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-2138
Mailing Address - Country:US
Mailing Address - Phone:214-208-5995
Mailing Address - Fax:817-255-7166
Practice Address - Street 1:1518 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-6718
Practice Address - Country:US
Practice Address - Phone:214-208-5995
Practice Address - Fax:817-255-7166
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX063841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical