Provider Demographics
NPI:1780863423
Name:KOZMINSKI, LINDA ANNE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANNE
Last Name:KOZMINSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 W SAINT MAARTENS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2953
Mailing Address - Country:US
Mailing Address - Phone:816-676-1500
Mailing Address - Fax:
Practice Address - Street 1:1009 W SAINT MAARTENS DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2953
Practice Address - Country:US
Practice Address - Phone:816-676-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0042411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical