Healthcare Provider Details

I. General information

NPI: 1558501197
Provider Name (Legal Business Name): PAULINE LOUISE LINTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 W 117TH ST APT 3D
NEW YORK NY
10026-1556
US

IV. Provider business mailing address

352 W 117TH ST APT 3D
NEW YORK NY
10026-1556
US

V. Phone/Fax

Practice location:
  • Phone: 212-222-6078
  • Fax:
Mailing address:
  • Phone: 212-222-6078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number044041
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: