Provider Demographics
NPI:1528373818
Name:SCHUBERT, LINDA BATEMAN (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:BATEMAN
Last Name:SCHUBERT
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 1:7665 INDIGO RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-5109
Mailing Address - Country:US
Mailing Address - Phone:817-343-9294
Mailing Address - Fax:817-306-2173
Practice Address - Street 1:601 N PARK BLVD
Practice Address - Street 2:NO. 401
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7833
Practice Address - Country:US
Practice Address - Phone:817-343-9294
Practice Address - Fax:817-306-2173
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12262OtherSTATE LICENSE NUMBER
TX1249963Medicaid
TX1249963Medicaid