Provider Demographics
NPI:1679770838
Name:LEVINE, LINDA (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEVINE
Other - Last Name:SCHIFLETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2201 COLD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76088-7297
Mailing Address - Country:US
Mailing Address - Phone:817-371-1388
Mailing Address - Fax:817-441-6179
Practice Address - Street 1:106 AUSTIN AVE STE 107
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-3381
Practice Address - Country:US
Practice Address - Phone:817-371-1388
Practice Address - Fax:817-594-5305
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299511041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX91KMOtherBCBS
TX1618654-01Medicaid
TX1618654-01Medicaid