Provider Demographics
NPI:1790433555
Name:WARINER, LINDA (ADT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WARINER
Suffix:
Gender:F
Credentials:ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S SMALLWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3397
Mailing Address - Country:US
Mailing Address - Phone:703-436-1987
Mailing Address - Fax:
Practice Address - Street 1:127 S SMALLWOOD ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3397
Practice Address - Country:US
Practice Address - Phone:703-436-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT2623101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)