Provider Demographics
NPI:1285809111
Name:ACKER, LINDA JEAN (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JEAN
Last Name:ACKER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 HIGHLAND WAY
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5823
Mailing Address - Country:US
Mailing Address - Phone:307-352-6680
Mailing Address - Fax:307-352-6676
Practice Address - Street 1:1124 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5863
Practice Address - Country:US
Practice Address - Phone:307-352-6680
Practice Address - Fax:307-352-6676
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC256101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional