Provider Demographics
NPI:1346857141
Name:HALL, LINDSAY (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 GILCREST AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1841
Mailing Address - Country:US
Mailing Address - Phone:248-509-5032
Mailing Address - Fax:
Practice Address - Street 1:2843 E GRAND RIVER AVE
Practice Address - Street 2:#120
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:248-509-5032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011142831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
15584284OtherCAQH ID
MI6801114283OtherSTATE LICENSE NUMBER
MI0972747OtherBCBSM PIN