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General NPI Number Information
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NPI Number | 1457737421
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Entity Type | Individual
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Provider Name | LINDA L SMALL L.I.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 62 WARE ST
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City | WEST BROOKFIELD
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State | MA
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Zip | 01585-3136
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Country | US
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Telephone | 508-867-4491
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Fax | 508-867-3555
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Provider Business Mailing Address
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Address Line | PO BOX 1125
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City | WEST BROOKFIELD
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State | MA
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Zip | 01585-1125
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Country | US
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Telephone | 508-867-4491
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Fax | 508-867-3555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 118483
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License Number State | MA
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