Provider Demographics
NPI:1730891318
Name:MORAN, LINDA SUE (LISW, ACSW, CADC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:MORAN
Suffix:
Gender:F
Credentials:LISW, ACSW, CADC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:SUE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW, ACSW, LMHP
Mailing Address - Street 1:520 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-0709
Mailing Address - Country:US
Mailing Address - Phone:712-828-7474
Mailing Address - Fax:712-322-4301
Practice Address - Street 1:520 N 7TH ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0709
Practice Address - Country:US
Practice Address - Phone:712-828-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22005101YA0400X
IA009411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)