Provider Demographics
NPI:1376136267
Name:WAY, LINDA LEE (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:WAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:THORP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:179 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-1018
Mailing Address - Country:US
Mailing Address - Phone:940-391-3709
Mailing Address - Fax:
Practice Address - Street 1:179 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-1018
Practice Address - Country:US
Practice Address - Phone:940-391-3709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional