Provider Demographics
NPI:1205160405
Name:LINEFSKY, JUSTIN SCOTT (LCSW)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:SCOTT
Last Name:LINEFSKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 W LOOCKERMAN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7325
Mailing Address - Country:US
Mailing Address - Phone:302-674-1397
Mailing Address - Fax:302-674-1602
Practice Address - Street 1:121 W LOOCKERMAN ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7325
Practice Address - Country:US
Practice Address - Phone:302-674-1397
Practice Address - Fax:302-674-1602
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079938104100000X
DEQ1-00011431041C0700X
NY73 0801211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker