Provider Demographics
NPI:1003335092
Name:BENNETT, LINDSAY (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:PRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7413 FAIRWAY CIRCLE EAST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9791
Mailing Address - Country:US
Mailing Address - Phone:317-670-2605
Mailing Address - Fax:
Practice Address - Street 1:7413 FAIRWAY CIRCLE EAST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9791
Practice Address - Country:US
Practice Address - Phone:317-670-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33007852A104100000X
IN34008329A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker