Provider Demographics
NPI:1255518452
Name:COMBS, LINDA (MSSA, LCSW, LMFT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:MSSA, LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2419
Mailing Address - Country:US
Mailing Address - Phone:973-412-2056
Mailing Address - Fax:973-412-8281
Practice Address - Street 1:274 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2419
Practice Address - Country:US
Practice Address - Phone:973-412-2056
Practice Address - Fax:973-412-8281
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003541001041C0700X
NJ37FI00155100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist