Provider Demographics
NPI:1225731508
Name:LINDNER, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LINDNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WINTER ST APT 5
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1659
Mailing Address - Country:US
Mailing Address - Phone:917-443-9525
Mailing Address - Fax:
Practice Address - Street 1:5 BUCKNAM RD STE 2C
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1209
Practice Address - Country:US
Practice Address - Phone:207-781-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health