Provider Demographics
NPI:1265888416
Name:MATTHEWS, LINDSAY (BCBA LBS)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:BCBA LBS
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:DRAGON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA LBS
Mailing Address - Street 1:183 BALDWIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1202
Mailing Address - Country:US
Mailing Address - Phone:267-879-4500
Mailing Address - Fax:
Practice Address - Street 1:183 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19127-1202
Practice Address - Country:US
Practice Address - Phone:267-879-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-15-18297103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst