Provider Demographics
NPI:1689234411
Name:MITCHELL, LINDSEY MARIE (LPC, CRC)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 CALEDONIA CIR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-1572
Mailing Address - Country:US
Mailing Address - Phone:859-227-6645
Mailing Address - Fax:
Practice Address - Street 1:15001 WALDEN RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-8578
Practice Address - Country:US
Practice Address - Phone:936-449-8053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
73645101YM0800X
TX73645103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health