Healthcare Provider Details

I. General information

NPI: 1033109640
Provider Name (Legal Business Name): LINDA MARIE BELDIN-KORTER PHD/LCSW/CADCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 07/21/2022
Certification Date: 07/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 LOS ARBOLES AVE NE
ALBUQUERQUE NM
87107-1943
US

IV. Provider business mailing address

16420 SE MCGILLIVRAY BLVD # 103-310
VANCOUVER WA
98683-3461
US

V. Phone/Fax

Practice location:
  • Phone: 505-800-7092
  • Fax: 505-888-2851
Mailing address:
  • Phone: 360-931-9122
  • Fax: 866-583-8290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17-10-02
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9978-C
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00005241
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801088449
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL3248
License Number StateOR
# 6
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-10615
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: