Provider Demographics
NPI:1104085430
Name:GROSSMAN, LINDA CLARE (LPC, CADCIII, LMHC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CLARE
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:LPC, CADCIII, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 N KNOXVILLE WAY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1210
Mailing Address - Country:US
Mailing Address - Phone:541-351-5589
Mailing Address - Fax:
Practice Address - Street 1:318 N KNOXVILLE WAY
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1210
Practice Address - Country:US
Practice Address - Phone:541-351-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13-12-78101YA0400X
ORC4601101YM0800X
101YP2500X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator