Provider Demographics
NPI:1467703108
Name:BIXBY, LINDA LORAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LORAINE
Last Name:BIXBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LORIE
Other - Middle Name:
Other - Last Name:BIXBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1615 OLD MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-7511
Mailing Address - Country:US
Mailing Address - Phone:434-203-6303
Mailing Address - Fax:
Practice Address - Street 1:1615 OLD MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-7511
Practice Address - Country:US
Practice Address - Phone:434-203-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040017731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical