Provider Demographics
NPI:1285741934
Name:HICKLING, LINDA P (LCSWR)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:P
Last Name:HICKLING
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7979 SAILBOAT KEY BLVD S APT 101
Mailing Address - Street 2:
Mailing Address - City:S PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-6355
Mailing Address - Country:US
Mailing Address - Phone:518-366-5295
Mailing Address - Fax:
Practice Address - Street 1:1106 DRUID RD S
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3846
Practice Address - Country:US
Practice Address - Phone:727-584-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 98561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB4005Medicare ID - Type UnspecifiedUPSTATE MEDICARE