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NPI Code Detail

MEDICARE: NICOLE LINDBERG

MEDICARE: NICOLE LINDBERG
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
1104100000XSocial Worker35038MN
2101YA0400XAddiction (Substance Use Disorder) Counselor307413MN

General Provider Information

NPI Number : 1265743900
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LINDBERG
Provider Business Mailing Address
First Line : 407 W BROADWAY AVE
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-1402
Country : US
Telephone Number : 612-236-8994
Fax Number :
Provider Business Practice Location Address
First Line : 407 W BROADWAY AVE
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-1402
Country : US
Telephone Number : 612-236-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2010
Last Update Date : 06/15/2026

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Directions to “ NICOLE LINDBERG ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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