Provider Demographics
NPI:1104505205
Name:LINDSAY, DEANN HARDY (LCSWA)
Entity type:Individual
Prefix:
First Name:DEANN
Middle Name:HARDY
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:DEANN
Other - Middle Name:HARDY
Other - Last Name:KISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:538 PENNYFIELDS LN
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-8267
Mailing Address - Country:US
Mailing Address - Phone:704-724-9230
Mailing Address - Fax:
Practice Address - Street 1:13425 HOOVER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-0169
Practice Address - Country:US
Practice Address - Phone:704-502-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0149801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical