Provider Demographics
NPI:1003015975
Name:LINDHORST, ERIC DEAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DEAN
Last Name:LINDHORST
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1108 CHESHIRE LANE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4814
Mailing Address - Country:US
Mailing Address - Phone:314-537-1391
Mailing Address - Fax:314-596-4627
Practice Address - Street 1:1066 EXECUTIVE PARKWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6340
Practice Address - Country:US
Practice Address - Phone:314-537-1391
Practice Address - Fax:314-596-4627
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010276531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431338511OtherUNITY