Provider Demographics
NPI:1679945786
Name:BRANCO, LINDA M (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:BRANCO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PHILADELPHIA PIKE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2280
Mailing Address - Country:US
Mailing Address - Phone:484-356-6687
Mailing Address - Fax:
Practice Address - Street 1:900 PHILADELPHIA PIKE
Practice Address - Street 2:SUITE C
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2280
Practice Address - Country:US
Practice Address - Phone:484-356-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional