Provider Demographics
NPI:1194875013
Name:KANDLE, LINDA M (MSS, LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:KANDLE
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 W DOREN TER
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-4348
Mailing Address - Country:US
Mailing Address - Phone:856-692-6969
Mailing Address - Fax:
Practice Address - Street 1:458 W DOREN TER
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4348
Practice Address - Country:US
Practice Address - Phone:856-692-6969
Practice Address - Fax:856-692-3929
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC043110001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical