Provider Demographics
NPI:1639864382
Name:O'ROURKE, LINDSAY CHRISTINE (LLPC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:CHRISTINE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 OAK VALLEY DR APT 206
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9175
Mailing Address - Country:US
Mailing Address - Phone:734-657-2561
Mailing Address - Fax:
Practice Address - Street 1:1601 BRIARWOOD CIR STE 400
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1650
Practice Address - Country:US
Practice Address - Phone:734-822-4998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022656101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty