Provider Demographics
NPI:1417236290
Name:SWAYDIS, LINDA MARY (LCSW - C)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARY
Last Name:SWAYDIS
Suffix:
Gender:F
Credentials:LCSW - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 BOSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2609
Mailing Address - Country:US
Mailing Address - Phone:410-769-9015
Mailing Address - Fax:
Practice Address - Street 1:857 PARK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4800
Practice Address - Country:US
Practice Address - Phone:410-244-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD098721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical