Provider Demographics
NPI:1235002700
Name:VAN KIRK, LINDA A (MS, MED)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:A
Last Name:VAN KIRK
Suffix:
Gender:F
Credentials:MS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3897 N CHRISTIAN CT
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-6909
Mailing Address - Country:US
Mailing Address - Phone:480-298-0454
Mailing Address - Fax:
Practice Address - Street 1:3897 N CHRISTIAN CT
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-6909
Practice Address - Country:US
Practice Address - Phone:480-298-0454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral