1184808446 NPI number — DR. LINDA JANE PARKER-WEBSTER PHD LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184808446 NPI number — DR. LINDA JANE PARKER-WEBSTER PHD LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER-WEBSTER
Provider First Name:
LINDA
Provider Middle Name:
JANE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEBSTER
Provider Other First Name:
LINDA
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1184808446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 E 5600 S
Provider Second Line Business Mailing Address:
SUITE 314
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107-6174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-266-6554
Provider Business Mailing Address Fax Number:
801-299-2416

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 E 5600 S
Provider Second Line Business Practice Location Address:
SUITE 314
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107-6174
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-266-6554
Provider Business Practice Location Address Fax Number:
801-299-2416
Provider Enumeration Date:
12/21/2007

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:  127489-3501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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