Provider Demographics
NPI:1205582566
Name:BECHTOLD, LINDSEY (AUD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BECHTOLD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:KOVACS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:355 W 16TH ST STE 3000
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2207
Practice Address - Country:US
Practice Address - Phone:317-944-6467
Practice Address - Fax:317-963-7085
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
IN23002868A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1102555077OtherANTHEM PTAN
IN300099718Medicaid