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NPI Code Detail

MEDICARE: MS. LINDA LEE MCNELLIS LCSW

MEDICARE: MS. LINDA LEE MCNELLIS LCSW
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
11041C0700XClinical Social Worker6821-CAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LW00008207OTHERWALICSW
2L2541OTHERORLCSW

General Provider Information

NPI Number : 1366417164
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA LEE MCNELLIS LCSW
Provider Business Mailing Address
First Line : 125 DONS WAY
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6478
Country : US
Telephone Number : 501-624-7111
Fax Number : 501-623-5510
Provider Business Practice Location Address
First Line : 125 DONS WAY
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6478
Country : US
Telephone Number : 501-624-7111
Fax Number : 501-623-5510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 06/20/2014

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