Provider Demographics
NPI:1538237680
Name:PLASTRIK, LINDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:PLASTRIK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTRAL AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3301
Mailing Address - Country:US
Mailing Address - Phone:914-271-6338
Mailing Address - Fax:914-271-6338
Practice Address - Street 1:1 BALTIC PL STE 201C
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-1655
Practice Address - Country:US
Practice Address - Phone:914-271-6338
Practice Address - Fax:914-271-6338
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR042688-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01955944Medicaid
NYR042688-1OtherNYS LICENSE
NY370319OtherMHN PROVIDER ID
NYP2395989OtherOXFORD PROVIDER ID
NYN3K821Medicare ID - Type UnspecifiedPROVIDER ID