Provider Demographics
NPI:1902816374
Name:CLOFINE, LINDA K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:K
Last Name:CLOFINE
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 1:2880 HADRIAN DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2292
Mailing Address - Country:US
Mailing Address - Phone:770-841-2966
Mailing Address - Fax:
Practice Address - Street 1:544 MEDLOCK RD
Practice Address - Street 2:STE. 106
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1515
Practice Address - Country:US
Practice Address - Phone:404-377-5727
Practice Address - Fax:404-377-5727
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0027421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical