MEDICARE: MS. LINDA A MERTENS LCSW, LMSW,CSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801069768	MI
2	1041C0700X	Clinical Social Worker	SW12451	FL

General Provider Information

NPI Number	:	1104912799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA A MERTENS LCSW, LMSW,CSW

Provider Business Mailing Address
First Line	:	1813 CURRY TRL
Second Line	:
City	:	NORTH VENICE
State	:	FL
Zip	:	34275-2962
Country	:	US
Telephone Number	:	586-381-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 CURRY TRL
Second Line	:
City	:	NORTH VENICE
State	:	FL
Zip	:	34275-2962
Country	:	US
Telephone Number	:	586-381-4345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/08/2015

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