Provider Demographics
NPI:1710181615
Name:LINGLEY, BRANDI L (LSW)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:L
Last Name:LINGLEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WESTBROOK COMMONS
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092
Mailing Address - Country:US
Mailing Address - Phone:207-856-1500
Mailing Address - Fax:207-282-7509
Practice Address - Street 1:12 WESTBROOK COMMONS
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092
Practice Address - Country:US
Practice Address - Phone:207-856-1500
Practice Address - Fax:207-282-7509
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELS7297101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health