Provider Demographics
NPI:1376782805
Name:LINDBERG, THERESA MARIE (CLINICAL SOCIAL WORK)
Entity Type:Individual
Prefix:MISS
First Name:THERESA
Middle Name:MARIE
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9A N PKWY DR
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5236
Mailing Address - Country:US
Mailing Address - Phone:518-269-6211
Mailing Address - Fax:
Practice Address - Street 1:9A N PKWY DR
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5236
Practice Address - Country:US
Practice Address - Phone:518-269-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical