Healthcare Provider Details
I. General information
NPI: 1356877898
Provider Name (Legal Business Name): LINDA SEXTON BA, CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/03/2017
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
41641 N RIDGE RD SUITE B.
ELYRIA OH
44035-1264
US
IV. Provider business mailing address
41641 N RIDGE RD SUITE B.
ELYRIA OH
44035-1264
US
V. Phone/Fax
- Phone: 440-324-7406
- Fax: 440-324-3609
- Phone: 440-324-7406
- Fax: 440-324-3609
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 120745 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: