Provider Demographics
NPI:1457876419
Name:AGOSTO, LINDA (MMHC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:AGOSTO
Suffix:
Gender:F
Credentials:MMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 PRESIDENTIAL WAY APT 408
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1870
Mailing Address - Country:US
Mailing Address - Phone:561-389-8923
Mailing Address - Fax:
Practice Address - Street 1:7731 N. MILITARY TRAIL
Practice Address - Street 2:SUITE 4
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-244-9499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health