Provider Demographics
NPI:1992892277
Name:LINDERMAN, MICHAEL W (MS, LCPC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:LINDERMAN
Suffix:
Gender:M
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LONE WOLF RD
Mailing Address - Street 2:
Mailing Address - City:TROUT CREEK
Mailing Address - State:MT
Mailing Address - Zip Code:59874-9641
Mailing Address - Country:US
Mailing Address - Phone:406-827-4487
Mailing Address - Fax:
Practice Address - Street 1:1342 BLUE SLIDE RD
Practice Address - Street 2:
Practice Address - City:THOMPSON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873-9472
Practice Address - Country:US
Practice Address - Phone:406-827-4344
Practice Address - Fax:406-827-5100
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT869 LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0256048Medicaid