Provider Demographics
NPI:1720184880
Name:STEAD, LINDA S (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:STEAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 SUPERIOR CT STE 103
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6179
Mailing Address - Country:US
Mailing Address - Phone:541-772-5993
Mailing Address - Fax:541-646-7969
Practice Address - Street 1:670 SUPERIOR CT STE 103
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6179
Practice Address - Country:US
Practice Address - Phone:541-772-5993
Practice Address - Fax:541-646-7969
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000THLGGMedicare ID - Type Unspecified