Provider Demographics
NPI:1124066519
Name:LINDEMANN, CHRISTOPHER M (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:LINDEMANN
Suffix:
Gender:M
Credentials:PHD
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 12225
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23612-2225
Mailing Address - Country:US
Mailing Address - Phone:757-873-4744
Mailing Address - Fax:757-873-6377
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 705K
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4256
Practice Address - Country:US
Practice Address - Phone:757-873-4744
Practice Address - Fax:757-873-6377
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002973103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007714424Medicaid
VA00V802V54Medicare ID - Type UnspecifiedMEDICARE NUMBER