Provider Demographics
NPI:1861524548
Name:HAINES, LINDA R (LCPC, LMFT, CADC)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:R
Last Name:HAINES
Suffix:
Gender:F
Credentials:LCPC, LMFT, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6607 N NEWGARD AVE
Mailing Address - Street 2:APT 1-SOUTH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4711
Mailing Address - Country:US
Mailing Address - Phone:773-743-7958
Mailing Address - Fax:
Practice Address - Street 1:6607 N NEWGARD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-4711
Practice Address - Country:US
Practice Address - Phone:773-743-7958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL17462OtherCADC CERTIFICATION