Healthcare Provider Details
I. General information
NPI: 1972680122
Provider Name (Legal Business Name): LINDA C. POLIN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1012 BETHLEHEM PIKE
SPRING HOUSE PA
19477-0086
US
IV. Provider business mailing address
210 CLOVER LN
AMBLER PA
19002-2401
US
V. Phone/Fax
- Phone: 215-646-5349
- Fax:
- Phone: 215-646-5349
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PS003178L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PS003178L |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 101331 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | BLUE SHIELD |
| # 2 | |
| Identifier | 0004528039 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | AETNA |
| # 3 | |
| Identifier | 2350978000 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | PERSONAL CHOICE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: