Provider Demographics
NPI:1760068944
Name:LINDSEY, KENYON (CEO, LAPC)
Entity Type:Individual
Prefix:
First Name:KENYON
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:CEO, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 BIG VALLEY TR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083
Mailing Address - Country:US
Mailing Address - Phone:770-898-2849
Mailing Address - Fax:770-899-2849
Practice Address - Street 1:4043 BIG VALLEY TR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083
Practice Address - Country:US
Practice Address - Phone:770-676-0766
Practice Address - Fax:770-676-0766
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor