Healthcare Provider Details

I. General information

NPI: 1548289895
Provider Name (Legal Business Name): JOANNE CLAIRE LINDBOM MSW LICSW ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 LADD ST. FOURTH FLOOR
PORTSMOUTH NH
03801
US

IV. Provider business mailing address

20 LADD ST. FOURTH FLOOR
PORTSMOUTH NH
03801
US

V. Phone/Fax

Practice location:
  • Phone: 603-433-7291
  • Fax: 603-433-6341
Mailing address:
  • Phone: 603-433-7291
  • Fax: 603-433-6341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberNH973
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: