Provider Demographics
NPI:1528653870
Name:SCHARTMAN, LINDA (MA, LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SCHARTMAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 NEWMARK AVE # 1028
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-4727
Mailing Address - Country:US
Mailing Address - Phone:541-252-3588
Mailing Address - Fax:541-314-9478
Practice Address - Street 1:281 LACLAIR ST
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420
Practice Address - Country:US
Practice Address - Phone:541-252-3588
Practice Address - Fax:541-314-9478
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7200101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528653870OtherNPI
OR500790431Medicaid
ORC7200OtherLICENSE NUMBER (LPC)
101YM0800XOtherTAXONOMY CODE
OR1528653870OtherOHP RENDERING PHYSICIAN NUMBER
15813221OtherCAQH PROVIDER ID