Provider Demographics
NPI:1285655688
Name:EDELSTEIN, LINDA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:EDELSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10356 OSPREY TRCE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-1543
Mailing Address - Country:US
Mailing Address - Phone:561-847-5522
Mailing Address - Fax:561-771-7111
Practice Address - Street 1:3801 PGA BLVD STE 600
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2756
Practice Address - Country:US
Practice Address - Phone:561-847-5522
Practice Address - Fax:561-771-1711
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI02275103T00000X
FLPY7933103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist