MEDICARE: MRS. LINDA VARNETT EMERSON L.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	079241	NY
2	1041C0700X	Clinical Social Worker	C007713	NC
3	1041C0700X	Clinical Social Worker	I 1302946	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	H221750	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	079241	OTHER	NY	NEW YORK STATE LICENSURE BOARD - L.C.S.W.
2	1331779	OTHER	NY	NEW YORK STATE DEPT OF EDUCATION PERMANENT SCHOOL SOCIAL WORKER
3	I 1302946	OTHER	OH	L.I.S.W.
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	C007713	OTHER	NC	NORTH CAROLINA LICENSURE BOARD - L.C.S.W.

General Provider Information

NPI Number	:	1902170772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA VARNETT EMERSON L.C.S.W.

Provider Business Mailing Address
First Line	:	1066 LEXINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-2250
Country	:	US
Telephone Number	:	419-526-5523
Fax Number	:

Provider Business Practice Location Address
First Line	:	1066 LEXINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-2250
Country	:	US
Telephone Number	:	419-526-5523
Fax Number	:

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

Provider Enumeration Date	:	02/27/2012
Last Update Date	:	03/24/2014

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Directions to “ MRS. LINDA VARNETT EMERSON L.C.S.W.” Practice Location

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