| Linda Divine, Lscsw, Llc | |
|
8340 Mission Rd Suite 230 Prairie Village KS 66206-1355 | |
| (913) 341-7447 | |
| (913) 341-7262 |
| Full Name | Linda Divine, Lscsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8340 Mission Rd, Prairie Village, Kansas |
| Authorized Official Name and Position | Linda Divine (OWNER) |
| Authorized Official Contact | 9133417447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Linda Divine, Lscsw, Llc 8340 Mission Rd Suite 230 Prairie Village KS 66206-1355 Ph: (913) 341-7447 | Linda Divine, Lscsw, Llc 8340 Mission Rd Suite 230 Prairie Village KS 66206-1355 Ph: (913) 341-7447 |
| NPI Number | 1982778940 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2567550593 |
|---|---|
| Medicare Enrollment ID | O20071108000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982778940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LSCSW0838 (Kansas) | Primary |
| Provider Name | Linda A Divine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306832506 PECOS PAC ID: 3971502220 Enrollment ID: I20061213000615 |
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