Provider Demographics
NPI:1962659458
Name:PATRICIA A LINDSAY PHD INC
Entity Type:Organization
Organization Name:PATRICIA A LINDSAY PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:435-658-9297
Mailing Address - Street 1:PO BOX 683966
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84068-3966
Mailing Address - Country:US
Mailing Address - Phone:435-658-9297
Mailing Address - Fax:
Practice Address - Street 1:1743 W REDSTONE CTR DR
Practice Address - Street 2:#115
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098
Practice Address - Country:US
Practice Address - Phone:435-658-9297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1161882501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT74005OtherMEDICARE ID TYPE, UNSPECIFIED
UTR61018Medicare UPIN
UT000057748Medicare PIN