Provider Demographics
NPI:1366762254
Name:VISAGGI, LINDA J (LCSW)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:VISAGGI
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 1:11213 HARBOUR SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1249
Mailing Address - Country:US
Mailing Address - Phone:561-350-9358
Mailing Address - Fax:561-451-2273
Practice Address - Street 1:2200 NW CORPORATE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7387
Practice Address - Country:US
Practice Address - Phone:561-350-9358
Practice Address - Fax:561-451-2273
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 40881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6870OtherBCBS
S01037Medicare UPIN