Provider Demographics
NPI:1659085611
Name:LINDSAY, JANA MARIE (MS, CRC, LCMHCA)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:MARIE
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:MS, CRC, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 BIG TREE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-8676
Mailing Address - Country:US
Mailing Address - Phone:570-351-2336
Mailing Address - Fax:
Practice Address - Street 1:110 OAKWOOD DR STE 450
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1913
Practice Address - Country:US
Practice Address - Phone:336-607-5822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDA18386101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health