Provider Demographics
NPI:1669555884
Name:GARRONE, LINDA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:GARRONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 FOSDICK RD
Mailing Address - Street 2:
Mailing Address - City:CARVER
Mailing Address - State:MA
Mailing Address - Zip Code:02330-1322
Mailing Address - Country:US
Mailing Address - Phone:508-866-7406
Mailing Address - Fax:508-866-7406
Practice Address - Street 1:38 FOSDICK RD
Practice Address - Street 2:
Practice Address - City:CARVER
Practice Address - State:MA
Practice Address - Zip Code:02330-1322
Practice Address - Country:US
Practice Address - Phone:508-866-7406
Practice Address - Fax:508-866-7406
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4957103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW04688OtherBCBS PROVIDER NUMBER
MA811853000OtherMAGELLAN PROVIDER NUMBER
MA6100032OtherEVERCARE PROVIDER NUMBER
MAA002122OtherVALUE OPTIONS PROV NUMBER
MAA002122OtherVALUE OPTIONS PROV NUMBER