Provider Demographics
NPI:1518213636
Name:LINDEMANN, MICHAEL DEAN (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DEAN
Last Name:LINDEMANN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 7TH AVE LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-4843
Mailing Address - Country:US
Mailing Address - Phone:763-248-0994
Mailing Address - Fax:763-270-8530
Practice Address - Street 1:3824 7TH AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-4843
Practice Address - Country:US
Practice Address - Phone:763-248-0994
Practice Address - Fax:763-270-8530
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional