Provider Demographics
NPI:1598484586
Name:WILSON, LYNDSAY ANN (MA)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:ANN
Last Name:WILSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 TWO MILE PIKE
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1836
Mailing Address - Country:US
Mailing Address - Phone:812-878-5747
Mailing Address - Fax:
Practice Address - Street 1:2031 N MOUNT JULIET RD STE 201
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4498
Practice Address - Country:US
Practice Address - Phone:615-438-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional