Healthcare Provider Details

I. General information

NPI: 1629050273
Provider Name (Legal Business Name): LINDA C. KANE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA EDWARDS MSW

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 12/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 NORTH PARHAM ROAD SUITE 3
RICHMOND VA
23233
US

IV. Provider business mailing address

2305 NORTH PARHAM ROAD SUITE 3
RICHMOND VA
23233
US

V. Phone/Fax

Practice location:
  • Phone: 804-270-1124
  • Fax: 804-270-2090
Mailing address:
  • Phone: 804-270-1124
  • Fax: 804-270-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904002004
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: