Provider Demographics
NPI:1073683181
Name:LINDER, VIVIAN (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:
Last Name:LINDER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WATERS EDGE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3255
Mailing Address - Country:US
Mailing Address - Phone:914-924-3170
Mailing Address - Fax:914-921-0046
Practice Address - Street 1:44 PURCHASE ST # 46
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3016
Practice Address - Country:US
Practice Address - Phone:914-924-3170
Practice Address - Fax:914-921-0046
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR069440-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2T941Medicare PIN