Provider Demographics
NPI:1114361318
Name:LINDBERG, ARLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:ARLEY
Middle Name:
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 150015
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94915-0015
Mailing Address - Country:US
Mailing Address - Phone:415-828-3533
Mailing Address - Fax:
Practice Address - Street 1:1206 3RD ST STE 6
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3048
Practice Address - Country:US
Practice Address - Phone:415-828-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA807471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical