Provider Demographics
NPI:1083081384
Name:CABRERA-REVOLORIO, LINDSY MARLYN (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSY
Middle Name:MARLYN
Last Name:CABRERA-REVOLORIO
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:LINDSY
Other - Middle Name:MARLYN
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:8 N MAIN ST
Mailing Address - Street 2:SUITE 504
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2282
Mailing Address - Country:US
Mailing Address - Phone:508-409-0000
Mailing Address - Fax:508-409-0006
Practice Address - Street 1:8 N MAIN ST
Practice Address - Street 2:SUITE 504
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2282
Practice Address - Country:US
Practice Address - Phone:508-409-0000
Practice Address - Fax:508-409-0006
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health