Individual
JACOB ANTHONY THOMAS LINDSTRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC-IT, SAC-IT
Contact information
Practice address
N3152 STATE ROAD 81, MONROE, WI 53566-8821
(608) 328-9352
Mailing address
N3152 STATE ROAD 81, MONROE, WI 53566-8821
(608) 328-9352
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19421
WI
101YP2500X
Professional Counselor
Primary
5338-226
WI
Other
Enumeration date
05/14/2021
Last updated
06/17/2022
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