MEDICARE: MRS. LINDA L SMALL L.I.C.S.W.

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	118483	MA

General Provider Information

NPI Number	:	1457737421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA L SMALL L.I.C.S.W.

Provider Business Mailing Address
First Line	:	176 WORCESTER PROVIDENCE TPKE STE 203
Second Line	:
City	:	SUTTON
State	:	MA
Zip	:	01590-1901
Country	:	US
Telephone Number	:	508-865-5900
Fax Number	:	508-865-5901

Provider Business Practice Location Address
First Line	:	176 WORCESTER PROVIDENCE TPKE STE 203
Second Line	:
City	:	SUTTON
State	:	MA
Zip	:	01590-1901
Country	:	US
Telephone Number	:	508-865-5900
Fax Number	:	508-865-5901

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

Provider Enumeration Date	:	07/31/2015
Last Update Date	:	05/12/2026

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