Provider Demographics
NPI:1427008358
Name:MASSA, LINDA A (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:MASSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OXFORD CIR
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1027
Mailing Address - Country:US
Mailing Address - Phone:215-641-9404
Mailing Address - Fax:
Practice Address - Street 1:100 LEVITTOWN PKWY
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-3502
Practice Address - Country:US
Practice Address - Phone:215-945-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013867101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA346881000OtherMAGELLAN MIS #
PA01661641OtherINDEPENDENCE BLUE CROSS