Provider Demographics
NPI:1144388596
Name:LINDSAY, CARLEY GAGE (LCSW)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:GAGE
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BRUTSCHER ST
Mailing Address - Street 2:STE D-353
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-6095
Mailing Address - Country:US
Mailing Address - Phone:503-706-5197
Mailing Address - Fax:
Practice Address - Street 1:120 S ELLIOTT RD
Practice Address - Street 2:STE 200
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2183
Practice Address - Country:US
Practice Address - Phone:503-706-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLO9411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical