Provider Demographics
NPI:1851462907
Name:LININGER, ROBERT STEWART (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEWART
Last Name:LININGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 ASHLAND ST S
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-2110
Mailing Address - Country:US
Mailing Address - Phone:763-689-5250
Mailing Address - Fax:
Practice Address - Street 1:133 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1552
Practice Address - Country:US
Practice Address - Phone:763-689-9407
Practice Address - Fax:763-552-0164
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0173103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN978381001195OtherPREFERRED ONE
MN61-04274OtherMEDICA
MN116171OtherU CARE
MN4H002LIOtherBLUE CROSS BLUE SHIELD