Jill Lindholm, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302430 Issued in MN

Practice address

403 4TH St NW Ste 300
Bemidji, MN 56601-3196

Phone

(218) 444-5155

Fax

(218) 333-3921

NPI assigned

May 30, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1063892511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 4TH ST NW STE 300",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013196",
            "telephone_number": "218-751-3280",
            "fax_number": "218-751-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 4TH ST NW STE 300",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013196",
            "telephone_number": "218-444-5155",
            "fax_number": "218-333-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDHOLM",
        "first_name": "JILL",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-30",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063892511",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Light Mountain Healthworks Inc.
• Stephanie Lind, RN
• Tessa Lindberg, OTR/L
• Lindell Consulting, LLC
• Tami Dawn Lindell, DNP, FNP, GNP, PMHNP
• Cody Link, OTR/L
• Randall Wayne Lish, DC
• Susanna Joy Little Elk, APRN, CNP
• Brian Paul Livermore, M.D.
• Sarah Marie Lofgren, MD

• Addiction (Substance Use Disorder) Counselor in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.