Provider Demographics
NPI:1922649987
Name:LASTING WELLNESS LLC
Entity Type:Organization
Organization Name:LASTING WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ST THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-204-1082
Mailing Address - Street 1:6 BELLE TER
Mailing Address - Street 2:
Mailing Address - City:COVINGTON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18424-7809
Mailing Address - Country:US
Mailing Address - Phone:858-204-1082
Mailing Address - Fax:
Practice Address - Street 1:116 DEPOT ST APT 2
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1878
Practice Address - Country:US
Practice Address - Phone:570-507-7649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty