Provider Demographics
NPI:1528032372
Name:ENFINGER, LINDA (RN, LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ENFINGER
Suffix:
Gender:F
Credentials:RN, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 CAPITAL MEDICAL BLVD
Mailing Address - Street 2:#2
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4671
Mailing Address - Country:US
Mailing Address - Phone:850-510-3336
Mailing Address - Fax:850-222-1194
Practice Address - Street 1:2880 CAPITAL MEDICAL BLVD
Practice Address - Street 2:#2
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4671
Practice Address - Country:US
Practice Address - Phone:850-510-3336
Practice Address - Fax:850-222-1194
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT11121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3133OtherBLUE CROSS PROV NUMBER