Provider Demographics
NPI:1104466127
Name:LINDBERG, LYNNE (LCSW)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 882
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0882
Mailing Address - Country:US
Mailing Address - Phone:541-429-8844
Mailing Address - Fax:541-429-8822
Practice Address - Street 1:200 SE HAILEY AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3073
Practice Address - Country:US
Practice Address - Phone:541-429-8844
Practice Address - Fax:541-429-8822
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155541041C0700X
ORL135631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical