Provider Demographics
NPI:1255701926
Name:LINDYBERG, ANNE (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:LINDYBERG
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-3145
Mailing Address - Country:US
Mailing Address - Phone:641-226-0478
Mailing Address - Fax:
Practice Address - Street 1:305 2ND AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1207
Practice Address - Country:US
Practice Address - Phone:319-333-7956
Practice Address - Fax:319-333-7956
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079943101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health