Basic Information
| Provider Information | |||||||||
| NPI: | 1952474298 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDE | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | JOAN | ||||||||
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| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1093 BEACON ST | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024465695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177346614 | ||||||||
| FaxNumber: | 6172673667 | ||||||||
| Practice Location | |||||||||
| Address1: | 1093 BEACON ST | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024465695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177346614 | ||||||||
| FaxNumber: | 6172673667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 3871 | MA | X | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103T00000X | 3871 | MA | X | Behavioral Health & Social Service Providers | Psychologist |
ID Information
| ID | Type | State | Issuer | Description | WO 3839 | 01 | MA | BCBS OF MA | OTHER | 1303546 | 05 | MA | MEDICAID | 8232-01 | 01 | MA | HARVARD PILGRIM | OTHER | 739463 | 01 | MA | TUFTS HEALTH PLAN | OTHER |