Linda L. Prudhomme, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L2635 Issued in OR

Practice address

4938 Sawmill Rd S
Salem, OR 97302-9730

Phone

(503) 990-1710

Fax

(503) 435-6469

NPI assigned

Aug 27, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1417263468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4938 SAWMILL RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029730",
            "telephone_number": "503-990-1710",
            "fax_number": "503-435-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4938 SAWMILL RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973029730",
            "telephone_number": "503-990-1710",
            "fax_number": "503-435-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDHOMME",
        "first_name": "LINDA",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Prosser, M.D.
• Hillary Kay Provance-Wheeler, LPC
• Providence Health & Services - Oregon (Prov Peds Neurology Salem)
• Providence Health & Services Oregon (Providence Medcial Group)
• Providence Health & Services Oregon (Providence Home Medical Equipment)
• Whitney Pruett, LPN
• Alicia Pruitt
• Christopher Thomas Prze, MD
• Holly Prze
• PT Northwest LLC

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.