Individual provider Active NPI

John Robert Lindbeck, LICSW

  • Clinical Social Worker
  • Lincoln, RI
National Provider Identifier
1376561357
Registry record updated Dec 19, 2016
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Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105326 Issued in MA
Practice address
1014 Lower River Rd
Lincoln, RI 02865-1231
Phone
(401) 333-0890
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 105326 MA Primary

Addresses

Primary practice location

1014 Lower River Rd
Lincoln, RI 02865-1231

Mailing address

1014 Lower River Rd
Lincoln, RI 02865-1231
Phone (401) 333-0890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 22, 2021 through Nov 22, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105326MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1376561357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 LOWER RIVER RD",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651231",
            "telephone_number": "401-333-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 LOWER RIVER RD",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651231",
            "telephone_number": "401-333-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBECK",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

Verify at the official NPI Registry.