Provider Demographics
NPI:1104924612
Name:LAFORGIA, LINDA ROGERS (MSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ROGERS
Last Name:LAFORGIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RALPH H JOHNSON VAMC
Mailing Address - Street 2:109 BEE ST, 11G
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401
Mailing Address - Country:US
Mailing Address - Phone:843-789-7094
Mailing Address - Fax:
Practice Address - Street 1:RALPH H JOHNSON VAMC
Practice Address - Street 2:109 BEE ST, 11G
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401
Practice Address - Country:US
Practice Address - Phone:843-789-7094
Practice Address - Fax:843-805-5786
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC48831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical