Provider Demographics
NPI:1386630887
Name:HINKLE, LINDA K (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:K
Last Name:HINKLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13295 ILLINOIS STREET
Mailing Address - Street 2:STE 321
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9006
Mailing Address - Country:US
Mailing Address - Phone:317-815-5680
Mailing Address - Fax:317-815-5904
Practice Address - Street 1:13295 ILLINOIS STREET
Practice Address - Street 2:STE 321
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9006
Practice Address - Country:US
Practice Address - Phone:317-815-5680
Practice Address - Fax:317-815-5904
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040626A103TC0700X, 103TB0200X, 103TF0000X, 103TH0100X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INR33567Medicare UPIN
IN166680Medicare ID - Type Unspecified