Provider Demographics
NPI:1417941493
Name:MEADE, LINDA S (PH D)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:MEADE
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:K
Other - Last Name:SWETLOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4328 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4402
Mailing Address - Country:US
Mailing Address - Phone:301-718-8000
Mailing Address - Fax:301-718-0018
Practice Address - Street 1:4328 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4402
Practice Address - Country:US
Practice Address - Phone:301-718-8000
Practice Address - Fax:301-718-0018
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1294103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
463315Medicare ID - Type Unspecified