Provider Demographics
NPI:1497101786
Name:PROCACCINI, LINDSAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:PROCACCINI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 LENOX ROAD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-4352
Mailing Address - Country:US
Mailing Address - Phone:203-257-1427
Mailing Address - Fax:
Practice Address - Street 1:425 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5410
Practice Address - Country:US
Practice Address - Phone:203-688-3182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0078361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical