Provider Demographics
NPI:1619111051
Name:LINDENSMITH, DARREL G (MA MS LPC)
Entity Type:Individual
Prefix:
First Name:DARREL
Middle Name:G
Last Name:LINDENSMITH
Suffix:
Gender:M
Credentials:MA MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-2921
Mailing Address - Country:US
Mailing Address - Phone:701-391-9131
Mailing Address - Fax:
Practice Address - Street 1:3030 OLD RED TRAIL ST.
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554
Practice Address - Country:US
Practice Address - Phone:701-391-9131
Practice Address - Fax:701-663-2763
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND424-7-1-99OtherNORTH DAKOTA BOARD OF COUNSELOR EXAMINERS