Provider Demographics
NPI:1073789343
Name:DECIMA, LINDSAY GAYLE
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:GAYLE
Last Name:DECIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 COLONIAL RD
Mailing Address - Street 2:UNIT 4
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-1619
Mailing Address - Country:US
Mailing Address - Phone:401-578-5742
Mailing Address - Fax:
Practice Address - Street 1:19 COLONIAL RD
Practice Address - Street 2:UNIT 4
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1619
Practice Address - Country:US
Practice Address - Phone:401-578-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker