Provider Demographics
NPI:1184808446
Name:PARKER-WEBSTER, LINDA JANE (PHD LCSW)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JANE
Last Name:PARKER-WEBSTER
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:JANE
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD LCSW
Mailing Address - Street 1:111 E 5600 S
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6174
Mailing Address - Country:US
Mailing Address - Phone:801-266-6554
Mailing Address - Fax:801-299-2416
Practice Address - Street 1:111 E 5600 S
Practice Address - Street 2:SUITE 314
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-6174
Practice Address - Country:US
Practice Address - Phone:801-266-6554
Practice Address - Fax:801-299-2416
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT127489-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000007118Medicare PIN