Provider Demographics
NPI:1851704381
Name:MILLBURG, LINDSEY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:MILLBURG
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 N STATE ROAD 341
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:IN
Mailing Address - Zip Code:47918-8022
Mailing Address - Country:US
Mailing Address - Phone:765-401-4460
Mailing Address - Fax:
Practice Address - Street 1:2930 N STATE ROAD 341
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:IN
Practice Address - Zip Code:47918-8022
Practice Address - Country:US
Practice Address - Phone:765-401-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008230A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical