Provider Demographics
NPI:1447510136
Name:CURE-HENDRICKSON, LINDSAY BERK (LADC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BERK
Last Name:CURE-HENDRICKSON
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13968 CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-5903
Mailing Address - Country:US
Mailing Address - Phone:218-454-1082
Mailing Address - Fax:218-454-1083
Practice Address - Street 1:13968 CYPRESS DR
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-5903
Practice Address - Country:US
Practice Address - Phone:218-454-1082
Practice Address - Fax:218-454-1083
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302893101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)