Provider Demographics
NPI:1225794985
Name:LINDENSMITH, DELAINA NICOLE
Entity Type:Individual
Prefix:MS
First Name:DELAINA
Middle Name:NICOLE
Last Name:LINDENSMITH
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:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-0115
Mailing Address - Country:US
Mailing Address - Phone:712-246-0159
Mailing Address - Fax:712-246-2879
Practice Address - Street 1:1977 G AVENUE
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566
Practice Address - Country:US
Practice Address - Phone:712-623-6349
Practice Address - Fax:712-623-6047
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health