Provider Demographics
NPI:1437028982
Name:SHOTWELL, LYNDSEY JOY
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:JOY
Last Name:SHOTWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 COLLEGE PARK DR # 141
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-6392
Mailing Address - Country:US
Mailing Address - Phone:682-803-4371
Mailing Address - Fax:
Practice Address - Street 1:172 COLLEGE PARK DR # 141
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6392
Practice Address - Country:US
Practice Address - Phone:682-803-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician