Provider Demographics
NPI:1215437298
Name:LINDER, ANDREW J (LPCC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:LINDER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 HOWE AVE # 1057
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4955
Mailing Address - Country:US
Mailing Address - Phone:330-203-1098
Mailing Address - Fax:
Practice Address - Street 1:1033 E TURKEYFOOT LAKE RD STE 104
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-7200
Practice Address - Country:US
Practice Address - Phone:330-703-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA165083101YA0400X
OHC1800921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268087Medicaid