Provider Demographics
NPI:1780660423
Name:MCGUIRE, LINDA GIBSON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:GIBSON
Last Name:MCGUIRE
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:PO BOX 471301
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28247-1301
Mailing Address - Country:US
Mailing Address - Phone:704-737-2397
Mailing Address - Fax:704-675-5701
Practice Address - Street 1:4716 BRYANSTONE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3268
Practice Address - Country:US
Practice Address - Phone:704-737-2397
Practice Address - Fax:704-675-5701
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0043331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC133UTOtherBLUE CROSS