Provider Demographics
NPI:1295895597
Name:COKER, LINDA SUE (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:COKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 STATE HIGHWAY 248
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-9241
Mailing Address - Country:US
Mailing Address - Phone:417-339-2535
Mailing Address - Fax:417-339-2634
Practice Address - Street 1:2404 STATE HIGHWAY 248
Practice Address - Street 2:SUITE #1
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-9241
Practice Address - Country:US
Practice Address - Phone:417-339-2535
Practice Address - Fax:417-339-2634
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0025371041C0700X
MO065595364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical