Provider Demographics
NPI:1760623045
Name:OVERBY, LINDA J (EDS, MS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:OVERBY
Suffix:
Gender:F
Credentials:EDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 ROSE PETAL CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2205
Mailing Address - Country:US
Mailing Address - Phone:702-277-7703
Mailing Address - Fax:702-433-8864
Practice Address - Street 1:329 ROSE PETAL CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-2205
Practice Address - Country:US
Practice Address - Phone:702-277-7703
Practice Address - Fax:702-433-8864
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01214-L101YA0400X
NV0622106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)