Provider Demographics
NPI:1235290719
Name:LINDO, STACEY (MA)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:
Last Name:LINDO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 BRALEY RD
Mailing Address - Street 2:#98
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745
Mailing Address - Country:US
Mailing Address - Phone:508-509-6592
Mailing Address - Fax:
Practice Address - Street 1:4 COURT ST
Practice Address - Street 2:SUITE 210
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3218
Practice Address - Country:US
Practice Address - Phone:508-681-9376
Practice Address - Fax:508-884-2476
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health