Provider Demographics
NPI:1114041639
Name:BLUM, LINDA SHARON (LCSW BCD)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SHARON
Last Name:BLUM
Suffix:
Gender:F
Credentials:LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MUCHMORE LN
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-7401
Mailing Address - Country:US
Mailing Address - Phone:631-283-8464
Mailing Address - Fax:
Practice Address - Street 1:7 MUCHMORE LN
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-7401
Practice Address - Country:US
Practice Address - Phone:631-283-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR01500811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical