Provider Demographics
NPI:1477237154
Name:DENNINGER, LINDSEY ROSE (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ROSE
Last Name:DENNINGER
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 1:101 RADIO AVE
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-3126
Mailing Address - Country:US
Mailing Address - Phone:631-871-6017
Mailing Address - Fax:
Practice Address - Street 1:285 E MAIN ST STE LL5
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2980
Practice Address - Country:US
Practice Address - Phone:631-724-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118880104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker