Provider Demographics
NPI:1316960172
Name:SOBO, LINDA (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SOBO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 TAUNTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1518
Mailing Address - Country:US
Mailing Address - Phone:203-270-1830
Mailing Address - Fax:203-270-3752
Practice Address - Street 1:36 TAUNTON LAKE DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1518
Practice Address - Country:US
Practice Address - Phone:203-270-1830
Practice Address - Fax:203-270-3752
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000520101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional