MEDICARE: LINDA S. ALLEN 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	LC1515	ME

General Provider Information

NPI Number	:	1760500136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA S. ALLEN MSW

Provider Business Mailing Address
First Line	:	PO BOX 1664
Second Line	:
City	:	BANGOR
State	:	ME
Zip	:	04402-1664
Country	:	US
Telephone Number	:	207-947-1353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 BUCK HILL DR
Second Line	:
City	:	VEAZIE
State	:	ME
Zip	:	04401-7009
Country	:	US
Telephone Number	:	207-947-1353
Fax Number	:

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/09/2007

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