Provider Demographics
NPI:1467600874
Name:LIND PSYCHOLOGICAL SERVICES INC
Entity Type:Organization
Organization Name:LIND PSYCHOLOGICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER LIND
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:360-738-4916
Mailing Address - Street 1:1112 11TH ST
Mailing Address - Street 2:301
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6654
Mailing Address - Country:US
Mailing Address - Phone:360-738-4916
Mailing Address - Fax:
Practice Address - Street 1:1112 11TH ST
Practice Address - Street 2:301
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6654
Practice Address - Country:US
Practice Address - Phone:360-738-4916
Practice Address - Fax:360-756-8850
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELLEN WALKER LIND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-28
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002522103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB24109Medicare UPIN