Provider Demographics
NPI:1376209817
Name:SMITH, LINDA MARIE (LICENSD PROFESSIONAL)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LICENSD PROFESSIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:MARLBORO GARDENS PROFESSIONAL BUILDING
Mailing Address - Street 2:470 HIGHWAY 79
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751
Mailing Address - Country:US
Mailing Address - Phone:732-762-1069
Mailing Address - Fax:
Practice Address - Street 1:MARLBORO GARDENS PROFESSIONAL BUILDING
Practice Address - Street 2:470 HIGHWAY 79
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751
Practice Address - Country:US
Practice Address - Phone:732-762-1069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00757600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional