Provider Demographics
NPI:1992932065
Name:LIND, PATRICIA DENISE (LCSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:DENISE
Last Name:LIND
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 1:1441 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0848
Mailing Address - Country:US
Mailing Address - Phone:530-224-2700
Mailing Address - Fax:530-226-1736
Practice Address - Street 1:1441 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0848
Practice Address - Country:US
Practice Address - Phone:530-224-2700
Practice Address - Fax:530-226-1736
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW35537101YM0800X
CALCSW610531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health