Provider Demographics
NPI:1437376043
Name:ENGEL, LINDA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:A
Last Name:ENGEL
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 1:214 BRECKENRIDGE LN
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3868
Mailing Address - Country:US
Mailing Address - Phone:502-899-9739
Mailing Address - Fax:
Practice Address - Street 1:214 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 107
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3868
Practice Address - Country:US
Practice Address - Phone:502-899-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY5991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000309226OtherANTHEM BL CROSS BL SHIELD
KYKY599OtherSOCIAL WORK LICENSE
063363OtherVALUE OPTIONS
5296461OtherAETNA