Provider Demographics
NPI:1619028776
Name:GUDAS, LINDA S (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:GUDAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 PICKERING ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-3159
Mailing Address - Country:US
Mailing Address - Phone:781-444-5666
Mailing Address - Fax:781-444-1567
Practice Address - Street 1:52 PICKERING ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-3159
Practice Address - Country:US
Practice Address - Phone:781-444-5666
Practice Address - Fax:781-444-1567
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5028103TC0700X, 103TC2200X, 103TC2200X
NH576103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent