Healthcare Provider Details

I. General information

NPI: 1508176959
Provider Name (Legal Business Name): SYDNEY JOAN LINDGREN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 418C
SPOKANE WA
99204-2318
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-6920
  • Fax: 509-474-6921
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-944-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberCG60159137
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60335662
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: