Provider Demographics
NPI:1912093469
Name:KARDOS, LINDA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:KARDOS
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 1:1466 HOOPER AVE
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2892
Mailing Address - Country:US
Mailing Address - Phone:732-600-7266
Mailing Address - Fax:732-202-8471
Practice Address - Street 1:1466 HOOPER AVE
Practice Address - Street 2:SUITE 1-C
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2892
Practice Address - Country:US
Practice Address - Phone:732-600-7266
Practice Address - Fax:732-202-8471
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC000746001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ638866Medicare PIN