Provider Demographics
NPI:1497779557
Name:LINDEMANN, RACHEL (LPC, LADC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:LINDEMANN
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 E 143
Mailing Address - Street 2:
Mailing Address - City:SASAKWA
Mailing Address - State:OK
Mailing Address - Zip Code:74867-7603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WETUMKA
Practice Address - State:OK
Practice Address - Zip Code:74883-4015
Practice Address - Country:US
Practice Address - Phone:405-452-5400
Practice Address - Fax:405-452-3000
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK107101YA0400X
OK3218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK300522336OtherMEDICARE