Provider Demographics
NPI:1962578062
Name:SANTANGELO, LINDA KAY (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:KAY
Last Name:SANTANGELO
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:102 EAGLEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0642
Mailing Address - Country:US
Mailing Address - Phone:702-896-3072
Mailing Address - Fax:702-896-0233
Practice Address - Street 1:6171 W CHARLESTON BLVD # 17
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1126
Practice Address - Country:US
Practice Address - Phone:702-486-8915
Practice Address - Fax:702-486-6307
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1996C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical