Provider Demographics
NPI:1184864894
Name:COLBURN-MALOUSEK, LINDSEY KAY (LP)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:KAY
Last Name:COLBURN-MALOUSEK
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LIMIT ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-4435
Mailing Address - Country:US
Mailing Address - Phone:913-682-5118
Mailing Address - Fax:913-682-4664
Practice Address - Street 1:500 LIMIT ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-4435
Practice Address - Country:US
Practice Address - Phone:913-682-5118
Practice Address - Fax:913-682-4664
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP 2471103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist