MEDICARE: LINDA MAY BLOCK-COALTER MSW

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	101YM0800X	Mental Health Counselor	900	KY

General Provider Information

NPI Number	:	1598750689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA MAY BLOCK-COALTER MSW

Provider Business Mailing Address
First Line	:	1646 COWLING AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-1370
Country	:	US
Telephone Number	:	502-454-0070
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 GARDINER LN
Second Line	:	SUITE 117
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-2962
Country	:	US
Telephone Number	:	502-454-0070
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/08/2007

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Directions to “ LINDA MAY BLOCK-COALTER MSW” Practice Location

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