Provider Demographics
NPI:1952878183
Name:LIND, DARREN MICHAEL (LADC)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:MICHAEL
Last Name:LIND
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 111TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MN
Mailing Address - Zip Code:56186-1011
Mailing Address - Country:US
Mailing Address - Phone:605-929-4546
Mailing Address - Fax:
Practice Address - Street 1:128 111TH ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:MN
Practice Address - Zip Code:56186-1011
Practice Address - Country:US
Practice Address - Phone:605-929-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302798101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty