Provider Demographics
NPI:1164232187
Name:NATHAN, LINDA M (MSW, MPA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:NATHAN
Suffix:
Gender:F
Credentials:MSW, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 ALDERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4837
Mailing Address - Country:US
Mailing Address - Phone:504-258-5616
Mailing Address - Fax:
Practice Address - Street 1:1201 ALDERWOOD LN
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4837
Practice Address - Country:US
Practice Address - Phone:504-258-5616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3959405300000X
172V00000X
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No405300000XOther Service ProvidersPrevention Professional
No172V00000XOther Service ProvidersCommunity Health Worker