Provider Demographics
NPI:1982721791
Name:LINDERMAN, LEON GORDON (LMSW)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:GORDON
Last Name:LINDERMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 W CAMBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1704
Mailing Address - Country:US
Mailing Address - Phone:248-252-8235
Mailing Address - Fax:
Practice Address - Street 1:346 W CAMBOURNE ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1704
Practice Address - Country:US
Practice Address - Phone:248-252-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801057796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801057796OtherLMSW
MI6801057796OtherLMSW