Provider Demographics
NPI:1568729226
Name:PADGETT, LINDA CAROL (MS)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CAROL
Last Name:PADGETT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 MOUNTFORT CT SW
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6469
Mailing Address - Country:US
Mailing Address - Phone:703-622-0447
Mailing Address - Fax:703-255-6128
Practice Address - Street 1:1013 MOUNTFORT CT SW
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-6469
Practice Address - Country:US
Practice Address - Phone:703-622-0447
Practice Address - Fax:703-255-6128
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional