Provider Demographics
NPI:1467462481
Name:AADLAND-LASSANDRO, LINDA J
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:AADLAND-LASSANDRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WILFORD HALL LOOP BLDG 4554
Mailing Address - Street 2:
Mailing Address - City:JBSA LACKLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5638
Mailing Address - Country:US
Mailing Address - Phone:210-292-7361
Mailing Address - Fax:
Practice Address - Street 1:WHASC/SGOWF
Practice Address - Street 2:1100 WILFORD HALL LOOP
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5103
Practice Address - Country:US
Practice Address - Phone:210-838-4521
Practice Address - Fax:210-292-0380
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385441041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87437QOtherBLUE CROSS BLUE SHIELD
TXPOO216524OtherRAIL ROAD
TX170624401Medicaid