Provider Demographics
NPI:1467783381
Name:DOUGLAS, LINDSAY (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:DOUGLAS
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 1:6000 LAMAR AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6440 NIEMAN RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3326
Practice Address - Country:US
Practice Address - Phone:913-826-4129
Practice Address - Fax:913-962-7843
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7564104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker