MEDICARE: LINDA MARIE PAOLUCCIO LPC, QMHP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		OR
2	101YM0800X	Mental Health Counselor	C4218	OR

General Provider Information

NPI Number	:	1871835090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA MARIE PAOLUCCIO LPC, QMHP

Provider Business Mailing Address
First Line	:	PO BOX 1787
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-0261
Country	:	US
Telephone Number	:	541-500-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 FILBERT ST
Second Line	:
City	:	FOREST GROVE
State	:	OR
Zip	:	97116-2532
Country	:	US
Telephone Number	:	541-500-8655
Fax Number	:	800-433-1396

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

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	01/21/2026

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