Provider Demographics
NPI:1437588571
Name:SMITH, LINDA GWYN (CSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:GWYN
Last Name:SMITH
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MARKET ST.
Mailing Address - Street 2:SJRMC-FHC
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501
Mailing Address - Country:US
Mailing Address - Phone:973-754-4233
Mailing Address - Fax:973-754-4259
Practice Address - Street 1:21 MARKET ST.
Practice Address - Street 2:SJRMC-FHC
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501
Practice Address - Country:US
Practice Address - Phone:973-754-4233
Practice Address - Fax:973-754-4259
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW00713200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker