Healthcare Provider Details
I. General information
NPI: 1740988146
Provider Name (Legal Business Name): LINN MENTAL HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/16/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
705 WASHINGTON BLVD STE 100
WILLIAMSPORT PA
17701-5355
US
IV. Provider business mailing address
2701 BLAIR ST
MONTOURSVILLE PA
17754-9313
US
V. Phone/Fax
- Phone: 570-506-4449
- Fax:
- Phone: 570-506-4449
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COURTNEY
LINN
Title or Position: OWNER/PRACTITIONER
Credential: CRNP
Phone: 570-506-4449