Healthcare Provider Details

I. General information

NPI: 1891163416
Provider Name (Legal Business Name): LINDA EVERARDO SPOTTS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2015
Last Update Date: 09/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 CHAPMAN RD 100B
NEWARK DE
19702-5490
US

IV. Provider business mailing address

37 DALTON DR
NEWARK DE
19702-2057
US

V. Phone/Fax

Practice location:
  • Phone: 302-292-1334
  • Fax: 302-292-1349
Mailing address:
  • Phone: 302-757-0501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001305
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: