Provider Demographics
NPI:1619194024
Name:SADOFF, LINDA C (LCSW, JD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:SADOFF
Suffix:
Gender:F
Credentials:LCSW, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 WATER ST.
Mailing Address - Street 2:
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347-1510
Mailing Address - Country:US
Mailing Address - Phone:207-621-8558
Mailing Address - Fax:207-621-8558
Practice Address - Street 1:338 WATER ST.
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-1510
Practice Address - Country:US
Practice Address - Phone:207-621-8558
Practice Address - Fax:207-621-8558
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC78171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME043715OtherANTHEM PROVIDER NUMBER
11540787OtherCAQH PROVIDER ID
SA MM9580Medicare ID - Type Unspecified