MEDICARE: LINDA A MERTENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1013454388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA A MERTENS

Provider Business Mailing Address
First Line	:	1813 CURRY TRAIL
Second Line	:
City	:	N VENICE
State	:	FL
Zip	:	34275
Country	:	US
Telephone Number	:	586-381-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 CURRY TRL
Second Line	:
City	:	NORTH VENICE
State	:	FL
Zip	:	34275-2962
Country	:	US
Telephone Number	:	586-381-4345
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	PENNY GRAY
Credential	:
Telephone Number	:	941-377-7622

Provider Enumeration Date	:	01/25/2017
Last Update Date	:	01/25/2017

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Directions to “LINDA A MERTENS ” Practice Location

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