Provider Demographics
NPI:1770775744
Name:SOFER, LINDA O (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:O
Last Name:SOFER
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 1:4315 PARK AVE
Mailing Address - Street 2:UNIT 3K
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-6565
Mailing Address - Country:US
Mailing Address - Phone:732-266-0286
Mailing Address - Fax:
Practice Address - Street 1:4315 PARK AVE
Practice Address - Street 2:UNIT 3K
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-6565
Practice Address - Country:US
Practice Address - Phone:732-266-0286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005208001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical