Provider Demographics
NPI:1437308038
Name:CARVER, LINDA (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CARVER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 LYSTER LN
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1415
Mailing Address - Country:US
Mailing Address - Phone:248-496-1612
Mailing Address - Fax:248-923-2096
Practice Address - Street 1:1000 W UNIVERSITY DR
Practice Address - Street 2:SUITE 308
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1873
Practice Address - Country:US
Practice Address - Phone:248-496-1612
Practice Address - Fax:248-923-2096
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2014-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010862521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI7581005OtherMEDICARE PTAN