Provider Demographics
NPI:1942623145
Name:LINDQUIST, JODI (LSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:HETTINGER
Mailing Address - State:ND
Mailing Address - Zip Code:58639-0550
Mailing Address - Country:US
Mailing Address - Phone:701-567-2967
Mailing Address - Fax:701-567-2498
Practice Address - Street 1:609 2ND AVE N
Practice Address - Street 2:
Practice Address - City:HETTINGER
Practice Address - State:ND
Practice Address - Zip Code:58639-7449
Practice Address - Country:US
Practice Address - Phone:701-567-2967
Practice Address - Fax:701-567-2498
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4632104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker