Provider Demographics
NPI:1841813946
Name:LINA SOARES, LCSW, LLC
Entity type:Organization
Organization Name:LINA SOARES, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SOARES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:541-230-8497
Mailing Address - Street 1:1923 SW BROOKLANE DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1627
Mailing Address - Country:US
Mailing Address - Phone:541-230-8497
Mailing Address - Fax:
Practice Address - Street 1:636 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4442
Practice Address - Country:US
Practice Address - Phone:541-230-8497
Practice Address - Fax:541-600-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty