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NPI Code Detail

MEDICARE: MS. DIANNE E LINDBERG MSW, LICSW

MEDICARE:  MS. DIANNE E LINDBERG  MSW, LICSW
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
11041C0700XClinical Social Worker710MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437157278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANNE E LINDBERG MSW, LICSW
Provider Business Mailing Address
First Line : 200 4TH AVE W
Second Line : GOVERNMENT CENTER RM 300
City : SHAKOPEE
State : MN
Zip : 55379-1220
Country : US
Telephone Number : 952-496-8481
Fax Number :
Provider Business Practice Location Address
First Line : 200 4TH AVE W
Second Line : GOVERNMENT CENTER RM 300
City : SHAKOPEE
State : MN
Zip : 55379-1220
Country : US
Telephone Number : 952-496-8558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 09/16/2010

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