Provider Demographics
NPI:1508455007
Name:OGDEN, LINDSEY MAE
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MAE
Last Name:OGDEN
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 1:2242 WILLIAMS HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26187-8266
Mailing Address - Country:US
Mailing Address - Phone:304-375-6480
Mailing Address - Fax:304-375-9914
Practice Address - Street 1:2242 WILLIAMS HWY STE 3
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:WV
Practice Address - Zip Code:26187-8266
Practice Address - Country:US
Practice Address - Phone:304-375-6480
Practice Address - Fax:304-375-9914
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV262171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator