Provider Demographics
NPI:1467515270
Name:HORRELL, LINDA A (MDIV, MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:A
Last Name:HORRELL
Suffix:
Gender:F
Credentials:MDIV, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7680 LINDBERGH DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-2138
Mailing Address - Country:US
Mailing Address - Phone:636-527-7615
Mailing Address - Fax:636-527-7635
Practice Address - Street 1:7680 LINDBERGH DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-2138
Practice Address - Country:US
Practice Address - Phone:314-599-6955
Practice Address - Fax:636-527-7635
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040293381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical