Healthcare Provider Details

I. General information

NPI: 1104730175
Provider Name (Legal Business Name): LINDA DICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA DUROVCOVA

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 PECK RD
TORRINGTON CT
06790-6107
US

IV. Provider business mailing address

240 HOLABIRD AVE
WINSTED CT
06098-1847
US

V. Phone/Fax

Practice location:
  • Phone: 860-724-2342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10134
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: