Provider Demographics
NPI:1265209647
Name:LINDGREN, GRACE E (LCSW)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:E
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 DILLO TRL
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-6314
Mailing Address - Country:US
Mailing Address - Phone:512-810-0813
Mailing Address - Fax:
Practice Address - Street 1:3804 AVENUE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-4906
Practice Address - Country:US
Practice Address - Phone:512-810-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX519351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical