Provider Demographics
NPI:1437713765
Name:LINZIESHAVERS, NAKIA (LCSW)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:
Last Name:LINZIESHAVERS
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:PO BOX 71384
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-7584
Mailing Address - Country:US
Mailing Address - Phone:510-593-8988
Mailing Address - Fax:
Practice Address - Street 1:3200 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-2726
Practice Address - Country:US
Practice Address - Phone:510-778-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty