MEDICARE: MS. ANNE LINDYBERG M.S., L.M.H.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	079943	IA

General Provider Information

NPI Number	:	1255701926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE LINDYBERG M.S., L.M.H.C.

Provider Business Mailing Address
First Line	:	204 E WASHINGTON AVE
Second Line	:
City	:	FAIRFIELD
State	:	IA
Zip	:	52556-3145
Country	:	US
Telephone Number	:	641-226-0478
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 2ND AVE SE STE 200
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-1207
Country	:	US
Telephone Number	:	319-333-7956
Fax Number	:	319-333-7956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2015
Last Update Date	:	08/05/2019

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