Provider Demographics
NPI:1497847453
Name:LINDGREN, KAY E (CSW-PIP)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:E
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:CSW-PIP
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 3450
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-3450
Mailing Address - Country:US
Mailing Address - Phone:605-719-7200
Mailing Address - Fax:
Practice Address - Street 1:915 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-3414
Practice Address - Country:US
Practice Address - Phone:605-719-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1309104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9234397OtherDAKOTACARE
SD4996437OtherWELLMARK
SD4996437OtherWELLMARK