Provider Demographics
NPI:1437705696
Name:MINTZ, LINDA PLATT (AMFT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:PLATT
Last Name:MINTZ
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2452, CHANGING FACES
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93457
Mailing Address - Country:US
Mailing Address - Phone:805-714-4651
Mailing Address - Fax:
Practice Address - Street 1:4124 ODIE LANE CHANGING FACES
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455
Practice Address - Country:US
Practice Address - Phone:805-714-4651
Practice Address - Fax:805-456-7858
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144887106H00000X
CAAMFT144887106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist