MEDICARE: MRS. LINDA SUE LUCHSINGER II SSW

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1952292518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA SUE LUCHSINGER II SSW

Provider Business Mailing Address
First Line	:	10892 S TOPVIEW RD
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84009-7743
Country	:	US
Telephone Number	:	702-480-0129
Fax Number	:	702-480-0129

Provider Business Practice Location Address
First Line	:	1338 S FOOTHILL DR # 333
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-2321
Country	:	US
Telephone Number	:	801-754-6051
Fax Number	:	801-210-0476

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

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	07/11/2025

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