Provider Demographics
NPI:1417262502
Name:HAUGEN, LINDSAY MYERS (LPC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MYERS
Last Name:HAUGEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:AUDRA
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:418 FLOYD CIR
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-5536
Mailing Address - Country:US
Mailing Address - Phone:912-463-4711
Mailing Address - Fax:
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:STE 1DO3
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-6933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005836101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional