Provider Demographics
NPI:1760686703
Name:FORTIN-CASE, LINDITH M (MSSW)
Entity Type:Individual
Prefix:
First Name:LINDITH
Middle Name:M
Last Name:FORTIN-CASE
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 TOWER DR W STE 200
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-7596
Mailing Address - Country:US
Mailing Address - Phone:651-439-2059
Mailing Address - Fax:888-675-8262
Practice Address - Street 1:1751 TOWER DR W STE 200
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-7596
Practice Address - Country:US
Practice Address - Phone:651-439-2059
Practice Address - Fax:888-675-8262
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MN187841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator