Healthcare Provider Details

I. General information

NPI: 1770996357
Provider Name (Legal Business Name): JENNIFER LINDSTROM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER BARNTHOUSE

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POWDERHOUSE RD
CHEYENNE WY
82009-4800
US

IV. Provider business mailing address

5050 POWDERHOUSE RD
CHEYENNE WY
82009-4800
US

V. Phone/Fax

Practice location:
  • Phone: 307-634-1311
  • Fax: 307-432-7546
Mailing address:
  • Phone: 307-634-1311
  • Fax: 307-432-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-1660
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: