Provider Demographics
NPI:1285979161
Name:HALL, LINDA (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 VAN BUSKIRK RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6329
Mailing Address - Country:US
Mailing Address - Phone:201-833-4016
Mailing Address - Fax:201-837-5140
Practice Address - Street 1:190 VAN BUSKIRK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6329
Practice Address - Country:US
Practice Address - Phone:201-833-4016
Practice Address - Fax:201-837-5140
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054078001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical