Provider Demographics
NPI:1235773565
Name:BRUMMELL, LINDSAY (LPC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BRUMMELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:SCHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1450 N COUNTY ROAD 2050 E
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-3551
Mailing Address - Country:US
Mailing Address - Phone:636-224-1210
Mailing Address - Fax:636-946-0991
Practice Address - Street 1:1450 N COUNTY ROAD 2050 E
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-3551
Practice Address - Country:US
Practice Address - Phone:217-357-6888
Practice Address - Fax:217-214-5450
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.015383101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL178.015326OtherIL LPC LICENSE
IL180.015383OtherIL LCPC LICENSE