Provider Demographics
NPI:1265416887
Name:BAXTER, LINDA R (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:BAXTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:465 N BELAIR RD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3188
Mailing Address - Country:US
Mailing Address - Phone:706-651-1383
Mailing Address - Fax:706-651-1383
Practice Address - Street 1:465 N BELAIR RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3188
Practice Address - Country:US
Practice Address - Phone:706-651-1260
Practice Address - Fax:706-651-1383
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GALPC002200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional