Provider Demographics
NPI:1528352382
Name:FLECKENSTEIN, LINDA L
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:FLECKENSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:FLECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD; LCSW
Mailing Address - Street 1:213 WOODHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1921
Mailing Address - Country:US
Mailing Address - Phone:914-946-3699
Mailing Address - Fax:914-289-0581
Practice Address - Street 1:213 WOODHAMPTON DR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1921
Practice Address - Country:US
Practice Address - Phone:914-946-3699
Practice Address - Fax:914-289-0581
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO19240-11041C0700X
NY1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool