Provider Demographics
NPI:1669068557
Name:SOLHEIM, LINDA SUE (RN, LAC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:SOLHEIM
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:SUE
Other - Last Name:STAPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5518 E HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5855
Mailing Address - Country:US
Mailing Address - Phone:602-565-1766
Mailing Address - Fax:
Practice Address - Street 1:401 W BASELINE RD STE 210
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5350
Practice Address - Country:US
Practice Address - Phone:480-307-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-17921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health