Provider Demographics
NPI:1376669762
Name:RICHARDS, LINDA L (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:L
Last Name:RICHARDS
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 1:5018 BAY LN
Mailing Address - Street 2:
Mailing Address - City:BACLIFF
Mailing Address - State:TX
Mailing Address - Zip Code:77518-1522
Mailing Address - Country:US
Mailing Address - Phone:409-218-6944
Mailing Address - Fax:
Practice Address - Street 1:2951 MARINA BAY DR STE 130-399
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2735
Practice Address - Country:US
Practice Address - Phone:409-218-6944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX554451041C0700X
CALCS220761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3801Medicaid