Healthcare Provider Details

I. General information

NPI: 1982064762
Provider Name (Legal Business Name): LINDA EVANS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N THIRD AVE
SANDPOINT ID
83864-1507
US

IV. Provider business mailing address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

V. Phone/Fax

Practice location:
  • Phone: 208-265-7121
  • Fax: 208-265-7129
Mailing address:
  • Phone: 208-265-7111
  • Fax: 208-265-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW43116
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW33784
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: