Provider Demographics
NPI:1174229231
Name:FORAN, LINDA LEATHERWOOD (LMFT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LEATHERWOOD
Last Name:FORAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 BANNISTER LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-2103
Mailing Address - Country:US
Mailing Address - Phone:917-868-8152
Mailing Address - Fax:
Practice Address - Street 1:96 BANNISTER LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-2103
Practice Address - Country:US
Practice Address - Phone:917-868-8152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001180106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist