Provider Demographics
NPI:1720040785
Name:VANDE GARDE, LINDA KAY (LSCSW KANSAS)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KAY
Last Name:VANDE GARDE
Suffix:
Gender:F
Credentials:LSCSW KANSAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3461 SW MACVICAR AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-1839
Mailing Address - Country:US
Mailing Address - Phone:785-267-1068
Mailing Address - Fax:785-267-0824
Practice Address - Street 1:3601 SW 29TH ST
Practice Address - Street 2:SUITE 216
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2015
Practice Address - Country:US
Practice Address - Phone:785-845-1067
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS044756OtherBLUE CROSS BLUE SHIELD
KS0447560880Medicare ID - Type Unspecified