Provider Demographics
NPI:1558784736
Name:MARTIN, LINDSEY PITTS (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:PITTS
Last Name:MARTIN
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 1:2600 GENERAL LEE WAY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7955
Mailing Address - Country:US
Mailing Address - Phone:334-398-0022
Mailing Address - Fax:
Practice Address - Street 1:200 BROAD ST SW
Practice Address - Street 2:SUITE 207
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3778
Practice Address - Country:US
Practice Address - Phone:334-398-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3550C1041C0700X
GACSW0050781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical