Provider Demographics
NPI:1417266008
Name:LINEBARGER, VANESSA EVANS (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:EVANS
Last Name:LINEBARGER
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2681
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-2681
Mailing Address - Country:US
Mailing Address - Phone:828-324-5463
Mailing Address - Fax:
Practice Address - Street 1:735 5TH STREET SW
Practice Address - Street 2:SUITE 2
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-324-5463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0018411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCANN7416Medicaid