Provider Demographics
NPI:1346095452
Name:LANDGREBE, LINDSEY (PHP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:LANDGREBE
Suffix:
Gender:F
Credentials:PHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 S PATTON CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4460
Mailing Address - Country:US
Mailing Address - Phone:217-622-3634
Mailing Address - Fax:
Practice Address - Street 1:1641 S PATTON CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-4460
Practice Address - Country:US
Practice Address - Phone:217-622-3634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6270103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling