Provider Demographics
NPI:1386737476
Name:GILL, LINDA SWAIN (MSN, MA, LPC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SWAIN
Last Name:GILL
Suffix:
Gender:F
Credentials:MSN, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 COLLINS DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-8316
Mailing Address - Country:US
Mailing Address - Phone:803-781-4872
Mailing Address - Fax:803-407-3581
Practice Address - Street 1:4766 SUNSET BOULEVARD, SUITE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9252
Practice Address - Country:US
Practice Address - Phone:803-407-3185
Practice Address - Fax:803-407-3581
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4713101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional