1992133243 NPI number — LINDSAY HAGER MA, LCPC

Table of content: LINDSAY HAGER MA, LCPC (NPI 1992133243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992133243 NPI number — LINDSAY HAGER MA, LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAGER
Provider First Name:
LINDSAY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROUSH
Provider Other First Name:
LINDSAY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LCPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992133243
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3428
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62708-3428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-588-2624
Provider Business Mailing Address Fax Number:
217-757-2021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
319 E MADISON ST STE 1F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-788-3948
Provider Business Practice Location Address Fax Number:
217-527-3209
Provider Enumeration Date:
10/24/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  180006833 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)