Provider Demographics
NPI:1669073367
Name:LINDEMANN, LISA (MA, NCC, LLPC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LINDEMANN
Suffix:
Gender:F
Credentials:MA, NCC, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 BASSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1713
Mailing Address - Country:US
Mailing Address - Phone:248-997-6424
Mailing Address - Fax:
Practice Address - Street 1:764 BASSWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1713
Practice Address - Country:US
Practice Address - Phone:248-997-6424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-08
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MI6401015622101YP2500X
MI6451015622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional