Provider Demographics
NPI:1487166740
Name:LINDHOLM, TASHA (LCSW)
Entity type:Individual
Prefix:MS
First Name:TASHA
Middle Name:
Last Name:LINDHOLM
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 1:7639 HULL STREET RD STE 102
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6438
Mailing Address - Country:US
Mailing Address - Phone:804-728-0522
Mailing Address - Fax:
Practice Address - Street 1:7639 HULL STREET RD STE 102
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6438
Practice Address - Country:US
Practice Address - Phone:804-728-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040099531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical