Active NPI
Linda Rae Taylor, LCSW
- Clinical Social Worker
- Mishawaka, IN
National Provider Identifier
1336210913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34004651A
- Practice address
- 113 Lincoln Way East
Mishawaka, IN 46544-2016 - Phone
- (574) 255-4976
- Fax
- (574) 255-1882
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34004651A | IN | Primary |
| Social Worker | 104100000X | 34004651 | IN |
Addresses
Primary practice location
113 Lincoln Way East
Mishawaka, IN 46544-2016
Mailing address
113 Lincoln Way East
Mishawaka, IN 46544-2016
Phone (574) 255-4976
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000341224 | Other | IN | ANTHEM |
| 7701931 | Other | IN | AETNA |
Other names 1
- Mrs. Linda Rae Stair
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34004651 | IN | MD | Social Worker |
| 34004651A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Counseling, PC | Social Worker | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Lincoln Therapeutic Partnership
- Social Worker
- South Bend, IN
- NPI 1083788426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200700800000",
"number": "1336210913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 LINCOLN WAY EAST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465442016",
"telephone_number": "574-255-4976",
"fax_number": "574-255-1882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 LINCOLN WAY EAST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465442016",
"telephone_number": "574-255-4976",
"fax_number": "574-255-1882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "LINDA",
"middle_name": "RAE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2008-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34004651A",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "34004651",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000341224",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7701931",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LINDA",
"last_name": "STAIR",
"middle_name": "RAE",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.