Provider Demographics
NPI:1134342587
Name:ESTERGARD, LINDA CARI (LCSW, PHD, PC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CARI
Last Name:ESTERGARD
Suffix:
Gender:F
Credentials:LCSW, PHD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MONROE PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8866
Mailing Address - Country:US
Mailing Address - Phone:503-675-2830
Mailing Address - Fax:503-675-2852
Practice Address - Street 1:9 MONROE PKWY STE 270
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8866
Practice Address - Country:US
Practice Address - Phone:503-675-2830
Practice Address - Fax:503-675-2852
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2106103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR161082OtherMEDICARE PTAN-INDIVIDUAL
ORR138282OtherMEDICARE PTAN-GROUP