Provider Demographics
NPI:1609095686
Name:BRACKIN, LINDA RUTH (MSS, LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:RUTH
Last Name:BRACKIN
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 ADAMS DAM RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19807-1438
Mailing Address - Country:US
Mailing Address - Phone:302-888-2345
Mailing Address - Fax:
Practice Address - Street 1:701 ADAMS DAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:DE
Practice Address - Zip Code:19807-1438
Practice Address - Country:US
Practice Address - Phone:302-888-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ10000282101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health