Provider Demographics
NPI:1275182511
Name:PRICE, LINDSAY NICOLE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:NICOLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N MAYFAIR RD STE 650
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1322
Mailing Address - Country:US
Mailing Address - Phone:414-771-9304
Mailing Address - Fax:
Practice Address - Street 1:2600 N MAYFAIR RD STE 650
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1322
Practice Address - Country:US
Practice Address - Phone:414-771-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1255-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist