Provider Demographics
NPI:1689155160
Name:BLOCK, LINDA (LICSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BLOCK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:BLOCK
Other - Last Name:SYNENKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:11 MARK RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1820
Mailing Address - Country:US
Mailing Address - Phone:978-766-5182
Mailing Address - Fax:
Practice Address - Street 1:24 MORRILL PL
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3530
Practice Address - Country:US
Practice Address - Phone:978-834-8474
Practice Address - Fax:978-834-8381
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10241911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical