Healthcare Provider Details

I. General information

NPI: 1801631783
Provider Name (Legal Business Name): SYDNEY LINDSTROM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SYDNEY SKJEI

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date: 01/29/2026
Reactivation Date: 02/11/2026

III. Provider practice location address

13603 80TH CIR N
MAPLE GROVE MN
55369-8961
US

IV. Provider business mailing address

13603 80TH CIR N
MAPLE GROVE MN
55369-8961
US

V. Phone/Fax

Practice location:
  • Phone: 763-274-3120
  • Fax: 763-274-3121
Mailing address:
  • Phone: 763-274-3120
  • Fax: 763-274-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: