Provider Demographics
NPI:1467794529
Name:HILDRETH, LINDSAY R (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:R
Last Name:HILDRETH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 MILLBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-3469
Mailing Address - Country:US
Mailing Address - Phone:651-600-6204
Mailing Address - Fax:
Practice Address - Street 1:900 6TH ST N STE 105
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-7172
Practice Address - Country:US
Practice Address - Phone:651-600-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WI1177-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health