Provider Demographics
NPI:1174512818
Name:STAPLETON, LINDA (LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E MAIN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189
Mailing Address - Country:US
Mailing Address - Phone:903-355-4336
Mailing Address - Fax:972-635-6264
Practice Address - Street 1:118 E MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3713
Practice Address - Country:US
Practice Address - Phone:903-355-4336
Practice Address - Fax:972-635-6264
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-16
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX347011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0064ELOtherBCBSTX PROVIDER NUMBER
TX0064ELOtherBCBSTX PROVIDER NUMBER