Provider Demographics
NPI:1558123679
Name:SKELTON, LINDSEY SUE (LACA, ADS)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:SUE
Last Name:SKELTON
Suffix:
Gender:F
Credentials:LACA, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4136
Mailing Address - Country:US
Mailing Address - Phone:765-592-0539
Mailing Address - Fax:
Practice Address - Street 1:619 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-1128
Practice Address - Country:US
Practice Address - Phone:765-592-0539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN80000059A171100000X
IN86900017A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171100000XOther Service ProvidersAcupuncturist