Provider Demographics
NPI:1962195602
Name:LINDLBAUER, DAVID ANDREW (LPCC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:LINDLBAUER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:ANDREW
Other - Last Name:ROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1707 MILLER TRUNK HWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-1880
Mailing Address - Country:US
Mailing Address - Phone:218-729-9238
Mailing Address - Fax:
Practice Address - Street 1:1707 MILLER TRUNK HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-1880
Practice Address - Country:US
Practice Address - Phone:218-729-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3797101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health