Provider Demographics
NPI:1023610771
Name:DE URQUIDI, LINDSAY TAYLOR (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:TAYLOR
Last Name:DE URQUIDI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:TAYLOR
Other - Last Name:CONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFTA
Mailing Address - Street 1:100 APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-2919
Mailing Address - Country:US
Mailing Address - Phone:706-936-1965
Mailing Address - Fax:
Practice Address - Street 1:3332 BRIDGES ST STE A
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3296
Practice Address - Country:US
Practice Address - Phone:252-726-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2488106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist