Provider Demographics
NPI:1023555141
Name:BALBOA, LINDSAY ELISE (CSWA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ELISE
Last Name:BALBOA
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 NE BELKNAP CT
Mailing Address - Street 2:STE 205
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5113
Mailing Address - Country:US
Mailing Address - Phone:503-560-5822
Mailing Address - Fax:888-503-2864
Practice Address - Street 1:4950 NE BELKNAP CT
Practice Address - Street 2:SUITE 205
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5113
Practice Address - Country:US
Practice Address - Phone:503-560-5822
Practice Address - Fax:888-503-2864
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical