Provider Demographics
NPI:1124173943
Name:KINNEY, LINDA MOORE (LCSW, CSAC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MOORE
Last Name:KINNEY
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 WHITEHORSE CT SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-2503
Mailing Address - Country:US
Mailing Address - Phone:703-779-1390
Mailing Address - Fax:
Practice Address - Street 1:210 WIRT ST SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2929
Practice Address - Country:US
Practice Address - Phone:703-340-8650
Practice Address - Fax:703-286-7030
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710000648101YA0400X
VA09040044771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical