Provider Demographics
NPI:1235524604
Name:DAVIS, LINDSAY NICHOLE (BCBA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:NICHOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:NICHOLE
Other - Last Name:ECCARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1209 HILL ROAD N PMB 176
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8888
Mailing Address - Country:US
Mailing Address - Phone:855-467-3272
Mailing Address - Fax:614-834-7977
Practice Address - Street 1:701 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8592
Practice Address - Country:US
Practice Address - Phone:855-467-3272
Practice Address - Fax:614-834-7977
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0-15-6476103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst