Provider Demographics
NPI:1609365683
Name:ADU, LYNDSAY MARTY
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:MARTY
Last Name:ADU
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 1:104 W CANDLER ST
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-1733
Mailing Address - Country:US
Mailing Address - Phone:770-246-2822
Mailing Address - Fax:
Practice Address - Street 1:104 W CANDLER ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-1733
Practice Address - Country:US
Practice Address - Phone:770-246-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-06
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst