MEDICARE: LINDA S BLEDSOE LSCSW

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	4033	KS
2	1041C0700X	Clinical Social Worker	61767	TX

General Provider Information

NPI Number	:	1316245830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA S BLEDSOE LSCSW

Provider Business Mailing Address
First Line	:	2000 S MAYS ST STE 201
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-7580
Country	:	US
Telephone Number	:	512-244-4272
Fax Number	:	512-244-2895

Provider Business Practice Location Address
First Line	:	135 BUNTON CREEK RD STE 302
Second Line	:
City	:	KYLE
State	:	TX
Zip	:	78640-5701
Country	:	US
Telephone Number	:	512-244-4272
Fax Number	:	512-244-2895

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2011
Last Update Date	:	06/15/2021

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Directions to “ LINDA S BLEDSOE LSCSW” Practice Location

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