Provider Demographics
NPI:1902825920
Name:JURANTY, LINDA (LICSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:JURANTY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3761
Mailing Address - Country:US
Mailing Address - Phone:603-228-3862
Mailing Address - Fax:603-226-0073
Practice Address - Street 1:6 S STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3761
Practice Address - Country:US
Practice Address - Phone:603-228-3862
Practice Address - Fax:603-226-0073
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30424035Medicaid
NHRE8160Medicare ID - Type Unspecified