Provider Demographics
NPI:1760852727
Name:HOLBEIN, LINDSAY D
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:D
Last Name:HOLBEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1046
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-7046
Mailing Address - Country:US
Mailing Address - Phone:703-477-8210
Mailing Address - Fax:
Practice Address - Street 1:616 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-4929
Practice Address - Country:US
Practice Address - Phone:443-801-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-03
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD$$$$$$$$$OtherSOCIAL SECURITY NUMBER