Healthcare Provider Details

I. General information

NPI: 1891618138
Provider Name (Legal Business Name): LINDA PACKARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 E WARNER RD STE 115
GILBERT AZ
85296-3056
US

IV. Provider business mailing address

690 E WARNER RD STE 115
GILBERT AZ
85296-3056
US

V. Phone/Fax

Practice location:
  • Phone: 480-444-2434
  • Fax: 480-588-8454
Mailing address:
  • Phone: 480-444-2434
  • Fax: 480-588-8454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-23828
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: