Healthcare Provider Details

I. General information

NPI: 1467928515
Provider Name (Legal Business Name): LINDA MORTON LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 7TH ST NE
WASHINGTON DC
20002-3610
US

IV. Provider business mailing address

810 7TH ST NE
WASHINGTON DC
20002-3610
US

V. Phone/Fax

Practice location:
  • Phone: 202-869-3743
  • Fax:
Mailing address:
  • Phone: 202-869-3743
  • Fax: 202-869-3842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLG50079674
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: