Provider Demographics
NPI:1588734669
Name:WALINSKI, LINDA MARIE (LP LICENSED PSYCHOLO)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:WALINSKI
Suffix:
Gender:F
Credentials:LP LICENSED PSYCHOLO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 267TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ISANTI
Mailing Address - State:MN
Mailing Address - Zip Code:55040
Mailing Address - Country:US
Mailing Address - Phone:763-444-5087
Mailing Address - Fax:320-679-6351
Practice Address - Street 1:905 FOREST AVE E
Practice Address - Street 2:STE 150
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051
Practice Address - Country:US
Practice Address - Phone:320-679-6350
Practice Address - Fax:320-679-6351
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3360103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN26A88WAOtherBLUE CROSS BLUE SHIELD
MN116224OtherUCARE BEHAVIORAL HEALTH P