Provider Demographics
NPI:1730467606
Name:GENTRY, LINDSAY SPRADLEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:SPRADLEY
Last Name:GENTRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2953 LAKE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1478
Mailing Address - Country:US
Mailing Address - Phone:770-530-4428
Mailing Address - Fax:
Practice Address - Street 1:2953 LAKE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1478
Practice Address - Country:US
Practice Address - Phone:770-530-4428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0034111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical