Provider Demographics
NPI:1205381431
Name:LUNDQUIST, LINDSAY (BCBA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:LUNDQUIST
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 STOCKBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0035
Mailing Address - Country:US
Mailing Address - Phone:586-292-7142
Mailing Address - Fax:
Practice Address - Street 1:4341 CHARLOTTE HWY STE 202
Practice Address - Street 2:
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710-7062
Practice Address - Country:US
Practice Address - Phone:704-586-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst