Provider Demographics
NPI:1144836008
Name:LINDEN, KERRY (NCC, LMHC)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:LINDEN
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 HUNTINGTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-3980
Mailing Address - Country:US
Mailing Address - Phone:757-634-1697
Mailing Address - Fax:
Practice Address - Street 1:3615 HUNTINGTON PLACE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-3980
Practice Address - Country:US
Practice Address - Phone:757-634-1697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health