Provider Demographics
NPI:1134512155
Name:LINDLEY, ANNE (BA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11685 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44046-8739
Mailing Address - Country:US
Mailing Address - Phone:216-217-1918
Mailing Address - Fax:
Practice Address - Street 1:11685 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:HUNTSBURG
Practice Address - State:OH
Practice Address - Zip Code:44046-8739
Practice Address - Country:US
Practice Address - Phone:216-217-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH103TC1900XMedicaid
OH103TC1900XMedicare PIN