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General NPI Number Information
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NPI Number | 1932765294
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Entity Type | Individual
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Provider Name | LINDA ROSE EAGLETON LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | IFH FAMILY PRACTICE CENTER 279 MAIN ST
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City | NEW PALTZ
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State | NY
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Zip | 12561
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Country | US
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Telephone | 845-229-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 2740 SOUTH RD APT D4
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601-5244
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Country | US
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Telephone | 845-337-0972
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Fax |
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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 | 095530
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License Number State | NY
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