Basic Information
| Provider Information | |||||||||
| NPI: | 1023147071 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINBERG | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | H | ||||||||
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| Mailing Information | |||||||||
| Address1: | 223 AVALON WAY | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023607785 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177826460 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14 FORDHAM RD | ||||||||
| Address2: | |||||||||
| City: | ALLSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021343006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177826460 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1027846 | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.