Provider Demographics
NPI:1962588269
Name:WEBB, LINDA LARIAR (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LARIAR
Last Name:WEBB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 STONE LINE RD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NY
Mailing Address - Zip Code:12421-1646
Mailing Address - Country:US
Mailing Address - Phone:607-326-4234
Mailing Address - Fax:607-326-4234
Practice Address - Street 1:166 STONE LINE RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NY
Practice Address - Zip Code:12421-1646
Practice Address - Country:US
Practice Address - Phone:607-326-4234
Practice Address - Fax:607-326-4234
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR030856-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN40902Medicare ID - Type UnspecifiedPROVIDER NUMBER