Provider Demographics
NPI:1295826758
Name:SMITH, LINDA S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:SMITH
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 1:19 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-7901
Mailing Address - Country:US
Mailing Address - Phone:203-238-3498
Mailing Address - Fax:
Practice Address - Street 1:839 ASYLUM AVE.
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06501
Practice Address - Country:US
Practice Address - Phone:860-728-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000349101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health