Provider Demographics
NPI:1760661045
Name:DICKSON, LINDA JOHNSON (LINDA DICKSON MS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JOHNSON
Last Name:DICKSON
Suffix:
Gender:F
Credentials:LINDA DICKSON MS
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:DICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LINDA JOHNSON
Mailing Address - Street 1:6 HESKETH ST
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4225
Mailing Address - Country:US
Mailing Address - Phone:301-951-6186
Mailing Address - Fax:
Practice Address - Street 1:5217 WISCONSIN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2075
Practice Address - Country:US
Practice Address - Phone:202-244-4995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500777431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical