Provider Demographics
NPI:1689094302
Name:RENFRO, LINDSEY IRENE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:IRENE
Last Name:RENFRO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 EAST NINTH AVENUE
Mailing Address - Street 2:SIERRA VISTA COUNSELING CENTER
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901
Mailing Address - Country:US
Mailing Address - Phone:575-743-1380
Mailing Address - Fax:575-743-1362
Practice Address - Street 1:800 EAST NINTH AVENUE
Practice Address - Street 2:SIERRA VISTA COUNSELING CENTER
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901
Practice Address - Country:US
Practice Address - Phone:575-743-1380
Practice Address - Fax:575-743-1362
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-08286104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker