Provider Demographics
NPI:1568402592
Name:KROLL, LINDA MARY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARY
Last Name:KROLL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:M KROLL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7704 PALM AIRE LN
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-3744
Mailing Address - Country:US
Mailing Address - Phone:941-504-5236
Mailing Address - Fax:941-761-1510
Practice Address - Street 1:7704 PALM AIRE LN
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-3744
Practice Address - Country:US
Practice Address - Phone:941-504-5236
Practice Address - Fax:941-761-1510
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW75441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688243996Medicaid