Provider Demographics
NPI:1710190079
Name:NATHAN, LINDA S (LICSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:NATHAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 LINCOLN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1743
Mailing Address - Country:US
Mailing Address - Phone:781-749-2089
Mailing Address - Fax:
Practice Address - Street 1:185 LINCOLN ST STE 210
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1743
Practice Address - Country:US
Practice Address - Phone:781-749-2089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1066531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical