Provider Demographics
NPI:1932765294
Name:EAGLETON, LINDA ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ROSE
Last Name:EAGLETON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ROSE
Other - Last Name:PISCITELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NYS TEACHER
Mailing Address - Street 1:2740 SOUTH RD APT D4
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5244
Mailing Address - Country:US
Mailing Address - Phone:845-337-0972
Mailing Address - Fax:
Practice Address - Street 1:IFH FAMILY PRACTICE CENTER
Practice Address - Street 2:279 MAIN ST
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561
Practice Address - Country:US
Practice Address - Phone:845-229-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0955301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical