Provider Demographics
NPI:1902023997
Name:DANIELS, LINDSEY SAMANTHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:SAMANTHA
Last Name:DANIELS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W. 40TH STREET
Mailing Address - Street 2:SUITE 454A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211
Mailing Address - Country:US
Mailing Address - Phone:410-814-1546
Mailing Address - Fax:410-467-0084
Practice Address - Street 1:711 W. 40TH STREET
Practice Address - Street 2:SUITE 454A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211
Practice Address - Country:US
Practice Address - Phone:410-814-1546
Practice Address - Fax:410-467-0084
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03627103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03627OtherLICENSE NUMBER