1649340944 NPI number — MS. LINDA SUE PASSEY LCSW(LICENSED CLINIC

Table of content: MS. LINDA SUE PASSEY LCSW(LICENSED CLINIC (NPI 1649340944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649340944 NPI number — MS. LINDA SUE PASSEY LCSW(LICENSED CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PASSEY
Provider First Name:
LINDA
Provider Middle Name:
SUE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW(LICENSED CLINIC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PASSEY
Provider Other First Name:
LINDA
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1649340944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
81 GREGORY LANE SUITE 220
Provider Second Line Business Mailing Address:
LINDA PASSEY, LCSW
Provider Business Mailing Address City Name:
PLEASANT HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-274-3678
Provider Business Mailing Address Fax Number:
925-686-2476

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81 GREGORY LANE SUITE 220
Provider Second Line Business Practice Location Address:
LINDA PASSEY, LCSW
Provider Business Practice Location Address City Name:
PLEASANT HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-274-3678
Provider Business Practice Location Address Fax Number:
925-686-2476
Provider Enumeration Date:
11/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  15973 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 136241-3501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)