Provider Demographics
NPI:1164295127
Name:IVORY, LINDSAY (LPC-A)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:IVORY
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6818 MERRILEE LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3131
Mailing Address - Country:US
Mailing Address - Phone:312-285-8991
Mailing Address - Fax:
Practice Address - Street 1:3890 W NORTHWEST HWY STE 640
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-8108
Practice Address - Country:US
Practice Address - Phone:214-890-8386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health