Provider Demographics
NPI:1275999112
Name:LEVISAY, LINDSAY (LPCC, NCC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:LEVISAY
Suffix:
Gender:F
Credentials:LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-7971
Mailing Address - Country:US
Mailing Address - Phone:270-779-7601
Mailing Address - Fax:
Practice Address - Street 1:1045 ELM ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2513
Practice Address - Country:US
Practice Address - Phone:270-843-1804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCPCC00218861101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor