Provider Demographics
NPI:1376165431
Name:CLANAGAN, LINDSAY R (MS, LAC)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:R
Last Name:CLANAGAN
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:RAE
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18015 W ACAPULCO LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-8733
Mailing Address - Country:US
Mailing Address - Phone:505-681-1723
Mailing Address - Fax:
Practice Address - Street 1:18015 W ACAPULCO LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-8733
Practice Address - Country:US
Practice Address - Phone:505-681-1723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-21781101YM0800X
AZ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health