Healthcare Provider Details

I. General information

NPI: 1295781367
Provider Name (Legal Business Name): LINDA ELIZABETH MCLEHOSE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 PHYLLIS DR STE G
PATCHOGUE NY
11772-2900
US

IV. Provider business mailing address

392 BERNICE DR
BAYPORT NY
11705-1204
US

V. Phone/Fax

Practice location:
  • Phone: 631-203-6202
  • Fax:
Mailing address:
  • Phone: 631-472-1731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR071203
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: