Provider Demographics
NPI:1356416655
Name:ATKINS, LINDA SUSAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUSAN
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:SUSAN
Other - Last Name:LOMBARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 SUN AVE NE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4659
Mailing Address - Country:US
Mailing Address - Phone:505-835-6764
Mailing Address - Fax:
Practice Address - Street 1:100 SUN AVE NE
Practice Address - Street 2:SUITE 650
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4659
Practice Address - Country:US
Practice Address - Phone:505-835-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC 046971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
201029345OtherPRESBYTERIAN
NM75059525Medicaid
NM75059525Medicaid