Provider Demographics
NPI:1659716124
Name:LINDSLEY, SONJA LOUISE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:LOUISE
Last Name:LINDSLEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4107
Mailing Address - Country:US
Mailing Address - Phone:406-541-4436
Mailing Address - Fax:406-541-4437
Practice Address - Street 1:301 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4107
Practice Address - Country:US
Practice Address - Phone:406-541-4436
Practice Address - Fax:406-541-4437
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2649101YA0400X
103K00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator