Healthcare Provider Details

I. General information

NPI: 1275225542
Provider Name (Legal Business Name): LINDA PADGETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 COUNTY ROUTE 23
CONSTANTIA NY
13044-3731
US

IV. Provider business mailing address

1602 COUNTY ROUTE 23
CONSTANTIA NY
13044-3731
US

V. Phone/Fax

Practice location:
  • Phone: 941-744-7432
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018332-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: