Healthcare Provider Details

I. General information

NPI: 1992985089
Provider Name (Legal Business Name): LINDA M SPEARING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S 100 E SUITE 11
KANAB UT
84741-3632
US

IV. Provider business mailing address

474 W 200 N SUITE 300
ST GEORGE UT
84770-4505
US

V. Phone/Fax

Practice location:
  • Phone: 435-644-4520
  • Fax: 435-644-4524
Mailing address:
  • Phone: 435-634-5600
  • Fax: 435-986-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number361057-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: