Provider Demographics
NPI:1578906707
Name:ENGELKING-COOPER, LINDA MARIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MARIA
Last Name:ENGELKING-COOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:MARIA
Other - Last Name:ENGELKING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1353 WATERSTON DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5038
Mailing Address - Country:US
Mailing Address - Phone:706-836-7620
Mailing Address - Fax:
Practice Address - Street 1:1353 WATERSTON DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-5038
Practice Address - Country:US
Practice Address - Phone:706-836-7620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW46641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical