Provider Demographics
NPI:1417085374
Name:ALFORD, LINDA GAIL
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GAIL
Last Name:ALFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:L
Other - Last Name:ALFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:10 EXECUTIVE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HAWTHORN WOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60047-7509
Mailing Address - Country:US
Mailing Address - Phone:847-540-9625
Mailing Address - Fax:
Practice Address - Street 1:10 EXECUTIVE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:HAWTHORN WOODS
Practice Address - State:IL
Practice Address - Zip Code:60047-7509
Practice Address - Country:US
Practice Address - Phone:847-540-9625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional