Provider Demographics
NPI:1760993091
Name:BRACE, LINDSEY JANEEN (LMSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JANEEN
Last Name:BRACE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 FOREST CT NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8114
Mailing Address - Country:US
Mailing Address - Phone:616-822-2263
Mailing Address - Fax:
Practice Address - Street 1:7700 FOREST CT NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-8114
Practice Address - Country:US
Practice Address - Phone:616-822-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010984011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical