Provider Demographics
NPI:1366436859
Name:EKSTRUM, LINDA J (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:EKSTRUM
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 1:2862 N BEVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1302
Mailing Address - Country:US
Mailing Address - Phone:520-321-9661
Mailing Address - Fax:520-791-0676
Practice Address - Street 1:6700 N ORACLE RD STE 505
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7736
Practice Address - Country:US
Practice Address - Phone:520-791-9974
Practice Address - Fax:520-791-0676
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health