Healthcare Provider Details

I. General information

NPI: 1174856769
Provider Name (Legal Business Name): LINDA M. HOWLEY-SKUBY M.S.W., L.C.S.W., CA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2009
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 WEST JEFFERSON STREET #501
BLOOMINGTON IL
61701
US

IV. Provider business mailing address

712 E EMPIRE ST
BLOOMINGTON IL
61701-3252
US

V. Phone/Fax

Practice location:
  • Phone: 309-828-1988
  • Fax: 309-828-6540
Mailing address:
  • Phone: 309-530-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1418
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1362616
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number149.002048
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: