Provider Demographics
NPI:1366651762
Name:WARREN, LINDA SUSAN (MSW LMSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUSAN
Last Name:WARREN
Suffix:
Gender:F
Credentials:MSW LMSW
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:SUSAN
Other - Last Name:KISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15241 REGINA
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101
Mailing Address - Country:US
Mailing Address - Phone:313-386-2426
Mailing Address - Fax:734-785-7734
Practice Address - Street 1:13101 ALLEN RD
Practice Address - Street 2:THE GUIDANCE CENTER
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2216
Practice Address - Country:US
Practice Address - Phone:734-785-7704
Practice Address - Fax:734-785-7734
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010640941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical