Provider Demographics
NPI:1417017310
Name:KUZMACK, LINDA GORDON (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:GORDON
Last Name:KUZMACK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9619 GLENCREST LN
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3514
Mailing Address - Country:US
Mailing Address - Phone:301-949-3268
Mailing Address - Fax:866-870-0717
Practice Address - Street 1:9619 GLENCREST LN
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3514
Practice Address - Country:US
Practice Address - Phone:301-949-3268
Practice Address - Fax:866-870-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC133351041C0700X
DCLC500782791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical