Provider Demographics
NPI:1326237066
Name:RAUCH, LINDA M (LPCC, LICDC, LSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:RAUCH
Suffix:
Gender:F
Credentials:LPCC, LICDC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5279 APPLECREEK RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5801
Mailing Address - Country:US
Mailing Address - Phone:937-435-1620
Mailing Address - Fax:
Practice Address - Street 1:3095 DAYTON-XENIA RD.
Practice Address - Street 2:SUITE 600
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434
Practice Address - Country:US
Practice Address - Phone:937-353-3292
Practice Address - Fax:937-352-3390
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH81623101YA0400X
OHE-0002534101YM0800X
OHS-0017471104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker