Provider Demographics
NPI:1942592050
Name:SWARTHOUT, LINDA MARIE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:SWARTHOUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 COUNTY CENTER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3004
Mailing Address - Country:US
Mailing Address - Phone:707-566-0170
Mailing Address - Fax:707-526-3155
Practice Address - Street 1:2400 COUNTY CENTER DR
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3004
Practice Address - Country:US
Practice Address - Phone:707-566-0170
Practice Address - Fax:707-526-3155
Is Sole Proprietor?:No
Enumeration Date:2011-05-07
Last Update Date:2011-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)