Provider Demographics
NPI:1710498373
Name:WHITAKER, LYNDSAY JORDAN (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:LYNDSAY
Middle Name:JORDAN
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 WHITNEY ST STE G2
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-3280
Mailing Address - Country:US
Mailing Address - Phone:774-314-2695
Mailing Address - Fax:774-209-4461
Practice Address - Street 1:305 WHITNEY ST STE G2
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3280
Practice Address - Country:US
Practice Address - Phone:774-314-2695
Practice Address - Fax:774-209-4461
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA11752-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health