Provider Demographics
NPI:1578336798
Name:LINDSEY, JEFFREY LEE JR (ACDA)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:LEE
Last Name:LINDSEY
Suffix:JR
Gender:M
Credentials:ACDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MOOSEHEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-2323
Mailing Address - Country:US
Mailing Address - Phone:207-300-5915
Mailing Address - Fax:
Practice Address - Street 1:689 ODLIN RD STE 1
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6709
Practice Address - Country:US
Practice Address - Phone:207-947-6800
Practice Address - Fax:207-947-6872
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAD8557101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)