Provider Demographics
NPI:1922088442
Name:HAMANN, LINDA (MS LP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HAMANN
Suffix:
Gender:F
Credentials:MS LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 CENTER AVE
Mailing Address - Street 2:STE 410
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560
Mailing Address - Country:US
Mailing Address - Phone:218-227-0338
Mailing Address - Fax:
Practice Address - Street 1:403 CENTER AVE
Practice Address - Street 2:STE 410
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-1975
Practice Address - Country:US
Practice Address - Phone:218-227-0338
Practice Address - Fax:218-227-0338
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 3183103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN075524OtherVALUE OPTIONS
MN30061-04OtherBHP
MN37286OtherBENEFIT PLAN ADM
ND23688OtherBCBS OF ND
MN30061-03OtherBHP
MN111056OtherHEALTH PARTNERS
MN111768OtherUCARE MINNESOTA
MN30061-02OtherBHP
MN62-58472OtherUBH
MN481216600Medicaid
MN171K1HAOtherBCBS OF MN
ND18311Medicaid