Provider Demographics
NPI:1740320928
Name:KANEFIELD, LINDA GAIL (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:GAIL
Last Name:KANEFIELD
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 1:5480 WISCONSIN AVE
Mailing Address - Street 2:SUITE 227
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3530
Mailing Address - Country:US
Mailing Address - Phone:301-654-2645
Mailing Address - Fax:301-654-1929
Practice Address - Street 1:5480 WISCONSIN AVE
Practice Address - Street 2:SUITE 227
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3530
Practice Address - Country:US
Practice Address - Phone:301-654-2645
Practice Address - Fax:301-654-1929
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2198103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical