Provider Demographics
NPI:1225580897
Name:JORDAN LINDH, PSY.D., LP L.L.C.
Entity Type:Organization
Organization Name:JORDAN LINDH, PSY.D., LP L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:651-482-9361
Mailing Address - Street 1:900 LONG LAKE RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6428
Mailing Address - Country:US
Mailing Address - Phone:651-482-9361
Mailing Address - Fax:
Practice Address - Street 1:900 LONG LAKE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6428
Practice Address - Country:US
Practice Address - Phone:651-482-9361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6052103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty