Provider Demographics
NPI:1942768072
Name:LINDQUIST, KRISTIN (PSYD LP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:PSYD LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 WASHINGTON AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-2878
Mailing Address - Country:US
Mailing Address - Phone:412-897-3493
Mailing Address - Fax:
Practice Address - Street 1:554 WASHINGTON AVE STE 4
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-2878
Practice Address - Country:US
Practice Address - Phone:412-897-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY025116-01103T00000X
PAPS019272103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health