Provider Demographics
NPI:1285815415
Name:LOCK, LINDA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:LOCK
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 1:520 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64124-1514
Mailing Address - Country:US
Mailing Address - Phone:816-404-6349
Mailing Address - Fax:816-404-6347
Practice Address - Street 1:300 W 19TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2026
Practice Address - Country:US
Practice Address - Phone:816-404-5709
Practice Address - Fax:816-404-5739
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020227221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical