Provider Demographics
NPI:1679817050
Name:CUNHA, LINDA LOU (MED)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LOU
Last Name:CUNHA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LOU
Other - Last Name:BURRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:80 ERDMAN WAY STE 208
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1840
Mailing Address - Country:US
Mailing Address - Phone:978-870-1840
Mailing Address - Fax:
Practice Address - Street 1:80 ERDMAN WAY STE 208
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1840
Practice Address - Country:US
Practice Address - Phone:978-870-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-25
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1481101Y00000X, 101YA0400X
101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional