Provider Demographics
NPI:1982065322
Name:MILBURY, LINDA (LICSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MILBURY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3097
Mailing Address - Country:US
Mailing Address - Phone:781-321-5348
Mailing Address - Fax:
Practice Address - Street 1:2221 HORSESHOE LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3097
Practice Address - Country:US
Practice Address - Phone:781-321-5348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-13
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1062681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical