Healthcare Provider Details

I. General information

NPI: 1588655054
Provider Name (Legal Business Name): LINDA L NEAL LIC SW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA L STARR LIC SW

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 KANAWHA AVE RAINELLE MEDICAL CENTER INC
RAINELLE WV
25962-1013
US

IV. Provider business mailing address

645 KANAWHA AVE RAINELLE MEDICAL CENTER INC
RAINELLE WV
25962-1013
US

V. Phone/Fax

Practice location:
  • Phone: 304-438-6188
  • Fax: 304-438-6819
Mailing address:
  • Phone: 304-438-6188
  • Fax: 304-438-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00942188
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: