Healthcare Provider Details

I. General information

NPI: 1942431937
Provider Name (Legal Business Name): LINDA L. RUTLEDGE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WEST YOUNG AVE.
ELMA WA
98541-0588
US

IV. Provider business mailing address

PO BOX 3030
ELMA WA
98541-0588
US

V. Phone/Fax

Practice location:
  • Phone: 360-249-2399
  • Fax: 360-262-0840
Mailing address:
  • Phone: 360-249-2399
  • Fax: 360-262-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH00004274
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00004274
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH00004274
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberLH00004274
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLH00004274
License Number StateWA
# 6
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberLH00004274
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLH00004272
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberLH00004274
License Number StateWA
# 9
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberLH00004272
License Number StateWA
# 10
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU00000460
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: