Provider Demographics
NPI:1356106868
Name:LINDSAY, MICHAEL DALE (PRSS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DALE
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11601 W STANLEY DRAPER DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73165-6503
Mailing Address - Country:US
Mailing Address - Phone:405-410-5907
Mailing Address - Fax:405-735-2598
Practice Address - Street 1:11601 W STANLEY DRAPER DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73165-6503
Practice Address - Country:US
Practice Address - Phone:405-410-5907
Practice Address - Fax:405-735-2598
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)