Provider Demographics
NPI:1417107319
Name:LINDA WINSHIP, LCSW, INC.
Entity Type:Organization
Organization Name:LINDA WINSHIP, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-436-2025
Mailing Address - Street 1:1260 CONCORD RD SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-5306
Mailing Address - Country:US
Mailing Address - Phone:770-436-2025
Mailing Address - Fax:770-436-2025
Practice Address - Street 1:1260 CONCORD RD SE
Practice Address - Street 2:SUITE 201
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-5306
Practice Address - Country:US
Practice Address - Phone:770-436-2025
Practice Address - Fax:770-436-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0002551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA975057701AMedicaid
GA80BBBCLMedicare PIN