Provider Demographics
NPI:1548458565
Name:NAZECK, LINDA SUE (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:NAZECK
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:SUE
Other - Last Name:DEMARY VAJGRT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1518 330TH
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:KS
Mailing Address - Zip Code:67483-7031
Mailing Address - Country:US
Mailing Address - Phone:785-643-7439
Mailing Address - Fax:
Practice Address - Street 1:670 MCGINNESS WAY
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442
Practice Address - Country:US
Practice Address - Phone:785-240-7243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2251104100000X, 1041C0700X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical