Healthcare Provider Details

I. General information

NPI: 1871608984
Provider Name (Legal Business Name): LINDA M. BABOLCSAY L.C.S.W., C.A.S.A.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 CHURCH ST
MALVERNE NY
11565-1735
US

IV. Provider business mailing address

348 BREAD AND CHEESE HOLLOW RD
NORTHPORT NY
11768-2636
US

V. Phone/Fax

Practice location:
  • Phone: 516-457-1807
  • Fax:
Mailing address:
  • Phone: 516-457-1807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number070109
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: