Provider Demographics
NPI:1356673545
Name:MILLIKIN, LINDSEY MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:MARIE
Last Name:MILLIKIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 DR. MARTIN LUTHER KING JR. DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61605-2400
Mailing Address - Country:US
Mailing Address - Phone:309-497-0790
Mailing Address - Fax:309-497-3564
Practice Address - Street 1:411 DR. MARTIN LUTHER KING JR. DRIVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61605-2400
Practice Address - Country:US
Practice Address - Phone:309-497-0790
Practice Address - Fax:309-497-3564
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0132011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical