Provider Demographics
NPI:1184970956
Name:LINDQUIST, ROBERT OWYN III (LSCW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:OWYN
Last Name:LINDQUIST
Suffix:III
Gender:M
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10609 S. GRANBY WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009
Mailing Address - Country:US
Mailing Address - Phone:801-808-3852
Mailing Address - Fax:
Practice Address - Street 1:10609 S. GRANBY WAY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009
Practice Address - Country:US
Practice Address - Phone:801-808-3852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT656626-35011041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical