1538630058 NPI number — KAITLIN LINDSAY STALLINGS LMHC

Table of content: KAITLIN LINDSAY STALLINGS LMHC (NPI 1538630058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538630058 NPI number — KAITLIN LINDSAY STALLINGS LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STALLINGS
Provider First Name:
KAITLIN
Provider Middle Name:
LINDSAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
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:
1538630058
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8520 ALLISON POINTE BLVD
Provider Second Line Business Mailing Address:
STE 223 PMB 91222
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46250-9767
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-805-0477
Provider Business Mailing Address Fax Number:
855-940-0157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8520 ALLISON POINTE BLVD
Provider Second Line Business Practice Location Address:
STE 223 PMB 91222
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46250-2073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-805-0477
Provider Business Practice Location Address Fax Number:
855-940-0157
Provider Enumeration Date:
12/10/2018

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: 101YM0800X , with the licence number:  39003986A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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