Provider Demographics
NPI:1588010144
Name:SMART-SULLIVAN, LINDA CLAIRE (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CLAIRE
Last Name:SMART-SULLIVAN
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 1:3425 SINCLAIR LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2030
Mailing Address - Country:US
Mailing Address - Phone:410-366-1151
Mailing Address - Fax:410-366-0032
Practice Address - Street 1:642 GAIRLOCH PL
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5721
Practice Address - Country:US
Practice Address - Phone:443-617-4254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03272104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker