1467841254 NPI number — MS. LINDSAY WALDEN MA, LPC, CST

Table of content: MS. LINDSAY WALDEN MA, LPC, CST (NPI 1467841254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467841254 NPI number — MS. LINDSAY WALDEN MA, LPC, CST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALDEN
Provider First Name:
LINDSAY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC, CST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467841254
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5446 ROSA AVE
Provider Second Line Business Mailing Address:
UNIT 2F
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63109-3246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-375-4778
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10176 CORPORATE SQUARE DR
Provider Second Line Business Practice Location Address:
SUITE 100-S
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63132-2924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-485-9189
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2015

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:  2010009458 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com