Provider Demographics
NPI:1447330063
Name:JAMES, LINELL WILLIAMS
Entity type:Individual
Prefix:
First Name:LINELL
Middle Name:WILLIAMS
Last Name:JAMES
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 1:5800 S FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2816
Mailing Address - Country:US
Mailing Address - Phone:480-897-2544
Mailing Address - Fax:480-838-1179
Practice Address - Street 1:5800 S FOREST AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2816
Practice Address - Country:US
Practice Address - Phone:480-897-2544
Practice Address - Fax:480-838-1179
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ569975Medicaid