Healthcare Provider Details

I. General information

NPI: 1881307072
Provider Name (Legal Business Name): LINDA MCLEHOSE, LCSW PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
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: 631-804-6608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MS. LINDA MCLEHOSE
Title or Position: OWNER/PRESIDENT
Credential: LCSW
Phone: 631-804-6608