Provider Demographics
NPI:1609990696
Name:KOLODNER, LINDA SHEPARD (MSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SHEPARD
Last Name:KOLODNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 N ST NW STE 301
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2914
Mailing Address - Country:US
Mailing Address - Phone:202-302-7082
Mailing Address - Fax:
Practice Address - Street 1:1712 N ST NW STE 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2914
Practice Address - Country:US
Practice Address - Phone:202-302-7082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC674686Medicare PIN