Provider Demographics
NPI:1336522093
Name:AMMONS, LINDSAY MARIE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MARIE
Last Name:AMMONS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1812
Mailing Address - Country:US
Mailing Address - Phone:202-735-6556
Mailing Address - Fax:
Practice Address - Street 1:1509 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1461
Practice Address - Country:US
Practice Address - Phone:202-289-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500802791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical