| Doctor Name: | LINDA LORAINE JOHANNISSON |
| NPI Number: | 1306979901 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-C |
| License Number: | 09266 |
| Business Practice Address: | 400 S Cross St Suite 1b Chestertown, MD - 216204752 |
| Business Phone Number: | 4107780835 |
| Business Fax Number: | 4107780836 |
| Mailing Address: | 400 S Cross St, Suite 1b CHESTERTOWN |
| State: | MD |
| Postal Code: | 216204752 |
| Phone Number: | 4107780835 |
| Fax Number: | 4107780836 |
| NPI Enumeration Date: | 03/13/2007 |
| NPI Last Update Date: | 07/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 09266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |