Provider Demographics
NPI:1326118852
Name:MITCHELL, LINDA DIANE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:DIANE
Last Name:MITCHELL
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 1:1550 MADRUGA AVE
Mailing Address - Street 2:SUITE 331
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3039
Mailing Address - Country:US
Mailing Address - Phone:305-662-2173
Mailing Address - Fax:305-662-2668
Practice Address - Street 1:1550 MADRUGA AVE
Practice Address - Street 2:SUITE 331
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3039
Practice Address - Country:US
Practice Address - Phone:305-662-2173
Practice Address - Fax:305-662-2668
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00020911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical