Healthcare Provider Details

I. General information

NPI: 1740001502
Provider Name (Legal Business Name): FIONA MARIE LINDGREN LPC A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11777A KATY FWY #350 SOUTH BUILDING
HOUSTON TX
77079
US

IV. Provider business mailing address

29306 SWEET ORANGE CT
KATY TX
77494
US

V. Phone/Fax

Practice location:
  • Phone: 713-365-0700
  • Fax:
Mailing address:
  • Phone: 281-813-6694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number96530
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: