Healthcare Provider Details

I. General information

NPI: 1801922026
Provider Name (Legal Business Name): LINDA E WHITTINGTON-CLARK PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W BANCROFT ST
TOLEDO OH
43607-1311
US

IV. Provider business mailing address

2525 W BANCROFT ST
TOLEDO OH
43607-1311
US

V. Phone/Fax

Practice location:
  • Phone: 419-578-2525
  • Fax: 419-536-9220
Mailing address:
  • Phone: 419-578-2525
  • Fax: 419-536-9220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4131
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number4131
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number4131
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4131
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4131
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number4131
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number4131
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number4131
License Number StateOH
# 9
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number4131
License Number StateOH
# 10
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number4131
License Number StateOH
# 11
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number4131
License Number StateOH
# 12
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number4131
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: